Provider Demographics
NPI:1447445341
Name:EUGENE J KALMUK MD PC
Entity type:Organization
Organization Name:EUGENE J KALMUK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KALMUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-893-4797
Mailing Address - Street 1:2625 HARLEM RD
Mailing Address - Street 2:SUITE 261
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4031
Mailing Address - Country:US
Mailing Address - Phone:716-893-4797
Mailing Address - Fax:716-893-1697
Practice Address - Street 1:2625 HARLEM RD
Practice Address - Street 2:SUITE 261
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-893-4797
Practice Address - Fax:716-893-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB0270Medicare PIN