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General NPI Number Information
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NPI Number | 1699971101
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Entity Type | Organization
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Legal Business Name | WESTCHESTER VITREO RETINAL, PC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 150 PURCHASE ST SUITE 6
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City | RYE
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State | NY
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Zip | 10580-2141
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Country | US
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Telephone | 914-967-5539
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Fax | 914-967-7149
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Provider Business Mailing Address
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Address Line | 150 PURCHASE ST SUITE 6
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City | RYE
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State | NY
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Zip | 10580-2141
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Country | US
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Telephone | 914-967-5539
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Fax | 914-967-7149
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL R KALKUT
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Credential | M.D.
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Telephone | 912-967-5539
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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 | 18998
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License Number State | NY
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