1649684572 NPI number — DR. CHRISTOS KALLIS MB.BS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649684572 NPI number — DR. CHRISTOS KALLIS MB.BS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALLIS
Provider First Name:
CHRISTOS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MB.BS
Provider Gender Code:
M

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:
1649684572
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 CIVIC CENTER BLVD, SOUTH PAVILION EXPANSION
Provider Second Line Business Mailing Address:
UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19104-5127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-615-1677
Provider Business Mailing Address Fax Number:
215-615-1688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5501 OLD YORK RD
Provider Second Line Business Practice Location Address:
ALBERT EINSTEIN MEDICAL CENTER
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19141-3018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-220-2362
Provider Business Practice Location Address Fax Number:
215-456-7926
Provider Enumeration Date:
06/18/2014

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: 207RN0300X , with the licence number:  MD466611 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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