Provider Demographics
NPI:1912106964
Name:MADHUMATI R KALAVAR, MD, PC
Entity Type:Organization
Organization Name:MADHUMATI R KALAVAR, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHUMATI
Authorized Official - Middle Name:R
Authorized Official - Last Name:KALAVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-469-6600
Mailing Address - Street 1:543 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3303
Mailing Address - Country:US
Mailing Address - Phone:516-481-2559
Mailing Address - Fax:
Practice Address - Street 1:566 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1821
Practice Address - Country:US
Practice Address - Phone:718-483-8360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190911207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG11740Medicare UPIN
NY44J481Medicare PIN