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General NPI Number Information
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NPI Number | 1154528586
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Entity Type | Individual
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Provider Name | GHASSEM KALANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 191 PRESIDENTIAL BLVD SUITE W1A
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1207
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Country | US
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Telephone | 610-668-1575
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Fax |
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Provider Business Mailing Address
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Address Line | 244 OLD LANCASTER RD PO BOX 160
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City | MERION STATION
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State | PA
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Zip | 19066-1750
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Country | US
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Telephone | 610-667-1214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD034579E
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License Number State | PA
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