Provider Demographics
NPI:1568693323
Name:KISHNER & CALISE P A
Entity Type:Organization
Organization Name:KISHNER & CALISE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:N
Authorized Official - Last Name:KISHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-928-0611
Mailing Address - Street 1:2021 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3763
Mailing Address - Country:US
Mailing Address - Phone:954-928-0611
Mailing Address - Fax:866-854-1909
Practice Address - Street 1:2021 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3763
Practice Address - Country:US
Practice Address - Phone:954-928-0611
Practice Address - Fax:866-854-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty