Provider Demographics
NPI:1669879250
Name:KALAM, ESHIKA
Entity type:Individual
Prefix:
First Name:ESHIKA
Middle Name:
Last Name:KALAM
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 1:6511 BOOTH STREET, SUITE 1A
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4184
Mailing Address - Country:US
Mailing Address - Phone:917-933-0584
Mailing Address - Fax:718-806-1435
Practice Address - Street 1:6511 BOOTH STREET, SUITE 1A
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4184
Practice Address - Country:US
Practice Address - Phone:917-933-0584
Practice Address - Fax:718-806-1435
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008186101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health