1326163528 NPI number — ROBERT W. KALISH, M.D., LTD

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 1326163528 NPI number — ROBERT W. KALISH, M.D., LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT W. KALISH, M.D., LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1326163528
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2450 OLD FORTY FOOT RD
Provider Second Line Business Mailing Address:
P.O. BOX 178
Provider Business Mailing Address City Name:
SKIPPACK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19474-0178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-222-0446
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2450 OLD FORTY FOOT RD
Provider Second Line Business Practice Location Address:
BOX 178
Provider Business Practice Location Address City Name:
SKIPPACK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19474-0178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-222-0446
Provider Business Practice Location Address Fax Number:
610-222-4101
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KALISH
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
W
Authorized Official Title or Position:
OWNER OPERATOR
Authorized Official Telephone Number:
610-222-0446

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  MD029379L , 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)

  • Identifier: 176269821 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 260010475 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18538 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 004325 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0046269000 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0046269000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 245004000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".




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