1396700795 NPI number — SANNA KALIKA MD

Table of content: SANNA KALIKA MD (NPI 1396700795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396700795 NPI number — SANNA KALIKA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALIKA
Provider First Name:
SANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396700795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
126 5TH AVE FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10011-5631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-880-4465
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 CRAIG RD STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANALAPAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07726-8735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-913-4433
Provider Business Practice Location Address Fax Number:
866-886-6548
Provider Enumeration Date:
04/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QS0010X , with the licence number:  331087014 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QS0010X , with the licence number: 760760601 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QS0010X , with the licence number: 043851266 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 25MA07968600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 096111-DCH . This is a "MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0080250 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4562836 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A0790 . This is a "BCBS HMO OB" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A0792 . This is a "BCBS HMO KP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00310583 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 096111-UJO . This is a "MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 096111-S3L . This is a "MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7670754 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A0791 . This is a "BCBS HMO AP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3835664 . This is a "OXFORD OB" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3835669 . This is a "OXFORD AP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3835677 . This is a "OXFORD KP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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