Provider Demographics
NPI:1740292838
Name:LALKA, JOSEPH P (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:LALKA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:159 JEFFERSON HTS, GMA SUITE A102
Mailing Address - Street 2:CATSKILL VA PRIMARY CARE
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-1204
Mailing Address - Country:US
Mailing Address - Phone:518-626-5240
Mailing Address - Fax:518-943-7289
Practice Address - Street 1:159 JEFFERSON HTS, GMA SUITE A102
Practice Address - Street 2:CATSKILL VA PRIMARY CARE
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1204
Practice Address - Country:US
Practice Address - Phone:518-626-5240
Practice Address - Fax:518-943-7289
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2012-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY139020207Q00000X
MA47307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00716174Medicaid
B18905Medicare UPIN
NY71A951Medicare PIN
MAA28483Medicare PIN
NYRA8931Medicare PIN