Basic Information
| Provider Information | |||||||||
| NPI: | 1073507653 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMTHAN | ||||||||
| FirstName: | ARVIND | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 707 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109402650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453337575 | ||||||||
| FaxNumber: | 8453333641 | ||||||||
| Practice Location | |||||||||
| Address1: | 263 FARMINGTON AVENUE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060308040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606792100 | ||||||||
| FaxNumber: | 8606794815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 07/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 1918661 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 208D00000X | 1918661 | NY | N | Allopathic & Osteopathic Physicians | General Practice | 207RH0003X | 063899 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 01807538 | 05 | NY | MEDICAID |