MEDICARE: JORDAN MARIE KALOSIEH 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	2084P0800X	Psychiatry Physician	109833	GA
2	2084P0800X	Psychiatry Physician	173806	FL
3	2084P0800X	Psychiatry Physician	335976	NY

General Provider Information

NPI Number	:	1851970065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN MARIE KALOSIEH MD

Provider Business Mailing Address
First Line	:	PO BOX 24449
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-0589
Country	:	US
Telephone Number	:	833-351-8255
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N MONROE ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-1549
Country	:	US
Telephone Number	:	833-351-8255
Fax Number	:

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

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	12/01/2025

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