Provider Demographics
NPI:1164425476
Name:KALTER, ALBERT R (DC)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:R
Last Name:KALTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WASHINGTON ST
Mailing Address - Street 2:STE 102
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4764
Mailing Address - Country:US
Mailing Address - Phone:781-848-8734
Mailing Address - Fax:781-848-9941
Practice Address - Street 1:400 WASHINGTON ST
Practice Address - Street 2:STE 102
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4764
Practice Address - Country:US
Practice Address - Phone:781-848-8734
Practice Address - Fax:781-848-9941
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH 825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1601938Medicaid
39413OtherMEDICARE LEGACY BC
MA603479OtherTUFTS
MA0005919OtherP-TAN
MA351914OtherHPHC
35673OtherMEDICARE LEGACY
MA1601938Medicaid