Healthcare Provider Details

I. General information

NPI: 1104896208
Provider Name (Legal Business Name): GARY KALMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 06/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 NEPTUNE AVE APARTMENT 8G
BROOKLYN NY
11224-4559
US

IV. Provider business mailing address

425 NEPTUNE AVE APARTMENT 8G
BROOKLYN NY
11224-4559
US

V. Phone/Fax

Practice location:
  • Phone: 718-372-5202
  • Fax:
Mailing address:
  • Phone: 718-372-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 031891-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: