Provider Demographics
NPI:1538136346
Name:KALAM, AZAD (MD)
Entity Type:Individual
Prefix:
First Name:AZAD
Middle Name:
Last Name:KALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-245-7467
Mailing Address - Fax:718-245-7469
Practice Address - Street 1:KINGS COUNTY HOSP CENTER, DEPT PSYCHIATRY
Practice Address - Street 2:SUSAN SMITH MCKINNEY NURSING AND REHAB CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-7000
Practice Address - Fax:718-245-7469
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY204484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G54334Medicare UPIN
24N571Medicare ID - Type Unspecified