Provider Demographics
NPI:1770805483
Name:KALLARACKEL, LEO JOSE (MBBS MRCPCH FRCR)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:JOSE
Last Name:KALLARACKEL
Suffix:
Gender:M
Credentials:MBBS MRCPCH FRCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26
Mailing Address - Street 2:
Mailing Address - City:BRIDGE COURT, SOUTH HARROW
Mailing Address - State:MIDDLESEX
Mailing Address - Zip Code:HA2 8FB
Mailing Address - Country:GB
Mailing Address - Phone:44786-334-6643
Mailing Address - Fax:
Practice Address - Street 1:26
Practice Address - Street 2:
Practice Address - City:BRIDGE COURT, SOUTH HARROW
Practice Address - State:MIDDLESEX
Practice Address - Zip Code:HA2 8FB
Practice Address - Country:GB
Practice Address - Phone:44786-334-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program