Provider Demographics
NPI:1043346950
Name:KALRA, JAGMOHAN K (MD)
Entity Type:Individual
Prefix:
First Name:JAGMOHAN
Middle Name:K
Last Name:KALRA
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 1:2500 MARCUS AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1018
Mailing Address - Country:US
Mailing Address - Phone:516-358-7700
Mailing Address - Fax:516-358-0319
Practice Address - Street 1:2500 MARCUS AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1018
Practice Address - Country:US
Practice Address - Phone:516-358-7700
Practice Address - Fax:516-358-0319
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY125112207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01682728Medicaid
NY56A831Medicare ID - Type Unspecified
NYC11357Medicare UPIN