Provider Demographics
NPI:1861721854
Name:DAVID KALKSTEIN MD PC
Entity type:Organization
Organization Name:DAVID KALKSTEIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KALKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-478-7981
Mailing Address - Street 1:555 E CITY AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1115
Mailing Address - Country:US
Mailing Address - Phone:610-660-8338
Mailing Address - Fax:610-660-8339
Practice Address - Street 1:555 E CITY AVE
Practice Address - Street 2:STE 210
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1115
Practice Address - Country:US
Practice Address - Phone:610-660-8338
Practice Address - Fax:610-660-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023723E261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)