Healthcare Provider Details

I. General information

NPI: 1992348494
Provider Name (Legal Business Name): KALEE HENNIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 US HIGHWAY 9 STE 1
VALATIE NY
12184-5423
US

IV. Provider business mailing address

PO BOX 186
NEW LEBANON NY
12125-0186
US

V. Phone/Fax

Practice location:
  • Phone: 518-758-6070
  • Fax: 518-758-6379
Mailing address:
  • Phone: 518-956-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054896
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: