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Individual

SIDNEY JACK KALISH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
156 HEWES ST, BROOKLYN, NY 11211-8901
(718) 797-3677
(718) 544-6668
Mailing address
14460 GRAVETT RD, FLUSHING, NY 11367-1351
(718) 544-2970
(718) 544-6668

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
113041
NY
207W00000X
Ophthalmology Physician
32123
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00204848
NY
Enumeration date
11/08/2005
Last updated
07/08/2007
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