MEDICARE: SERGEI KALSOW MD PC

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	2086S0122X	Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1437081601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERGEI KALSOW MD PC

Provider Business Mailing Address
First Line	:	635 MADISON AVE FL 17
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1009
Country	:	US
Telephone Number	:	212-653-8726
Fax Number	:	212-653-8726

Provider Business Practice Location Address
First Line	:	635 MADISON AVE FL 17
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1009
Country	:	US
Telephone Number	:	212-653-8726
Fax Number	:	212-653-8726

Authorized Official
Title or Position	:	OWNER
Name	:	SERGEI KALSOW
Credential	:	MD
Telephone Number	:	352-246-1775

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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