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General NPI Number Information
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NPI Number | 1669164463
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Entity Type | Individual
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Provider Name | SARA JESSICA KALISH NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 462 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-9196
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Country | US
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Telephone | 929-455-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 321 E 22ND ST
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City | NEW YORK
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State | NY
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Zip | 10010-4802
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Country | US
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Telephone | 770-362-9665
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 351726
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 351726
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 351726
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License Number State | NY
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