Provider Demographics
NPI:1043634470
Name:KALKHOF, KRISTIE (MSED)
Entity type:Individual
Prefix:MISS
First Name:KRISTIE
Middle Name:
Last Name:KALKHOF
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 HOFFMAN LN
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3108
Mailing Address - Country:US
Mailing Address - Phone:516-356-8524
Mailing Address - Fax:
Practice Address - Street 1:386 HOFFMAN LN
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3108
Practice Address - Country:US
Practice Address - Phone:516-356-8524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2155875174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist