Healthcare Provider Details

I. General information

NPI: 1356146559
Provider Name (Legal Business Name): KAKOLI HALDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 WESTCHESTER AVE APT 2D
BRONX NY
10462-5064
US

IV. Provider business mailing address

2265 WESTCHESTER AVE APT 2D
BRONX NY
10462-5064
US

V. Phone/Fax

Practice location:
  • Phone: 917-442-8582
  • Fax:
Mailing address:
  • Phone: 917-442-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number973555
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number973555
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number973555
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number973555
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number973555
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number973555
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number973555
License Number StateNY
# 8
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number973555
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: