Provider Demographics
NPI:1548799836
Name:KALMAR FAMILY PODIATRY LLP
Entity Type:Organization
Organization Name:KALMAR FAMILY PODIATRY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BOEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-549-0955
Mailing Address - Street 1:62 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6912
Mailing Address - Country:US
Mailing Address - Phone:631-549-0955
Mailing Address - Fax:631-424-1696
Practice Address - Street 1:62 GREEN STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6812
Practice Address - Country:US
Practice Address - Phone:631-549-0955
Practice Address - Fax:631-424-1696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00403636Medicaid
NY03723168Medicaid