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General NPI Number Information
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NPI Number | 1760654966
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Entity Type | Organization
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Legal Business Name | EDWARD KALTEN, PT, PC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 10 GORDON DR
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City | SYOSSET
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State | NY
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Zip | 11791-4718
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Country | US
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Telephone | 516-293-8224
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Fax | 631-360-2602
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Provider Business Mailing Address
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Address Line | 10 GORDON DR
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City | SYOSSET
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State | NY
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Zip | 11791-4718
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Country | US
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Telephone | 516-293-8224
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Fax | 631-360-2602
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | MR. EDWARD KALTEN JR.
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Credential | PT
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Telephone | 516-293-8224
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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 | 021499-1
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License Number State | NY
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