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General NPI Number Information
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NPI Number | 1538469069
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Entity Type | Individual
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Provider Name | ANDREW KALODIS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 106 GRAHAM AVE
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City | BROOKLYN
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State | NY
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Zip | 11206-3320
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Country | US
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Telephone | 718-782-7539
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ROUTE 299
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City | HIGHLAND
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State | NY
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Zip | 12528-2627
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Country | US
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Telephone | 917-225-8145
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 044912
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License Number State | NY
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