Healthcare Provider Details

I. General information

NPI: 1144462284
Provider Name (Legal Business Name): KALDAS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 ROUTE 32
HIGHLAND MILLS NY
10930-5150
US

IV. Provider business mailing address

535 ROUTE 32
HIGHLAND MILLS NY
10930-5150
US

V. Phone/Fax

Practice location:
  • Phone: 845-928-3003
  • Fax: 845-928-1063
Mailing address:
  • Phone: 845-928-3003
  • Fax: 845-928-1063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number031492
License Number StateNY

VIII. Authorized Official

Name: MRS. MONA MIKHAIL
Title or Position: OWNER
Credential:
Phone: 845-928-3003