Provider Demographics
NPI:1356146559
Name:HALDER, KAKOLI
Entity type:Individual
Prefix:
First Name:KAKOLI
Middle Name:
Last Name:HALDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 WESTCHESTER AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5064
Mailing Address - Country:US
Mailing Address - Phone:917-442-8582
Mailing Address - Fax:
Practice Address - Street 1:2265 WESTCHESTER AVE APT 2D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5064
Practice Address - Country:US
Practice Address - Phone:917-442-8582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY973555163WH1000X, 163WI0500X, 163W00000X, 163WH0200X, 163WM1400X, 163WW0000X, 163WX1500X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care