Healthcare Provider Details

I. General information

NPI: 1558660720
Provider Name (Legal Business Name): TRO KALAYJIAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2011
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 ROUTE 303
BLAUVELT NY
10913-1916
US

IV. Provider business mailing address

564 ROUTE 303
BLAUVELT NY
10913-1916
US

V. Phone/Fax

Practice location:
  • Phone: 845-397-2873
  • Fax: 888-674-7069
Mailing address:
  • Phone: 845-397-2873
  • Fax: 888-647-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB09475200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number89983508
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: