Provider Demographics
NPI:1598977217
Name:EKLOF, KALIROY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:KALIROY
Middle Name:A
Last Name:EKLOF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PITCAIRN AVE
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1623
Mailing Address - Country:US
Mailing Address - Phone:201-447-2598
Mailing Address - Fax:201-447-1949
Practice Address - Street 1:4 PITCAIRN AVE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1623
Practice Address - Country:US
Practice Address - Phone:201-447-2598
Practice Address - Fax:201-447-1949
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00099300103T00000X, 103TB0200X, 103TC0700X, 103TC2200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJEK625647Medicare PIN