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General NPI Number Information
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NPI Number | 1124209655
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Entity Type | Organization
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Legal Business Name | JAGMOHAN K KALRA MD PC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 2500 MARCUS AVENUE SUITE 110
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-358-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 MARCUS AVENUE SUITE 110
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAGMOHAN K KALRA
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Credential | M.D.
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Telephone | 516-358-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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