MEDICARE: DR. MARIA OLGA KALAFATIC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	208000000X	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043304959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA OLGA KALAFATIC MD

Provider Business Mailing Address
First Line	:	1 SHOREWOOD DR
Second Line	:
City	:	SANDS POINT
State	:	NY
Zip	:	11050-1908
Country	:	US
Telephone Number	:	718-328-2013
Fax Number	:	347-726-3308

Provider Business Practice Location Address
First Line	:	1575 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-328-2013
Fax Number	:	347-726-3308

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/24/2007

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