Provider Demographics
NPI:1245742444
Name:KALISH, HANNA C (JD)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:C
Last Name:KALISH
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1296 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3701
Mailing Address - Country:US
Mailing Address - Phone:617-738-6440
Mailing Address - Fax:
Practice Address - Street 1:1296 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3701
Practice Address - Country:US
Practice Address - Phone:617-738-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies