Provider Demographics
NPI:1033295761
Name:KAELBER, ARLENE (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:KAELBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4875 SUNRISE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-4630
Mailing Address - Country:US
Mailing Address - Phone:631-444-4686
Mailing Address - Fax:631-444-4622
Practice Address - Street 1:4875 SUNRISE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-4630
Practice Address - Country:US
Practice Address - Phone:631-444-4686
Practice Address - Fax:631-444-4622
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172918207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61923Medicare UPIN
NY29E001Medicare ID - Type UnspecifiedEMPIRE MEDICARE