Healthcare Provider Details

I. General information

NPI: 1043304959
Provider Name (Legal Business Name): MARIA OLGA KALAFATIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 WESTCHESTER AVE
BRONX NY
10472-2912
US

IV. Provider business mailing address

1 SHOREWOOD DR
SANDS POINT NY
11050-1908
US

V. Phone/Fax

Practice location:
  • Phone: 718-328-2013
  • Fax: 347-726-3308
Mailing address:
  • Phone: 718-328-2013
  • Fax: 347-726-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number208000000X
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: