Individual
DR. JAMES EDWARD KALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 RETREAT AVE, HARTFORD, CT 06106-2528
(860) 522-5712
(860) 520-4270
Mailing address
100 RETREAT AVE, HARTFORD, CT 06106-2528
(860) 522-5712
(860) 520-4270
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
019484
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001194844
—
CT
01
—
010019484CT01
ANTHEM BCBS ID#
CT
01
—
0521150446
CONNECTICARE ID#
CT
01
—
13459
HEALTH NEW ENGLAND ID#
CT
01
—
2043107
AETNA ID#
CT
01
—
2266768003
CIGNA ID#
CT
01
—
OS2283
HEALTHNET ID#
CT
01
—
P12038342
MULTIPLAN ID#
CT
01
—
P1236548
OXFORD HEALTH ID#
CT
Enumeration date
07/27/2005
Last updated
05/26/2011
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