Provider Demographics
NPI:1770967739
Name:KALLIATH, NAOMI JEAN (DO)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:JEAN
Last Name:KALLIATH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:27 PARK STREET
Mailing Address - Street 2:CAPE COD HOSPITAL
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5317
Mailing Address - Country:US
Mailing Address - Phone:508-957-1700
Mailing Address - Fax:
Practice Address - Street 1:27 PARK STREET
Practice Address - Street 2:CAPE COD HOSPITAL
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-0260
Practice Address - Country:US
Practice Address - Phone:508-957-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2021-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2874272086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology