Healthcare Provider Details

I. General information

NPI: 1144073792
Provider Name (Legal Business Name): DAVID PHILLIP KALTER M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 POND ST
WATERTOWN MA
02472-2564
US

IV. Provider business mailing address

4 POND ST
WATERTOWN MA
02472-2564
US

V. Phone/Fax

Practice location:
  • Phone: 202-487-7911
  • Fax:
Mailing address:
  • Phone: 202-487-7911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: