Individual
DR. RANDY J KALISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5416
Mailing address
4567 CROSSROADS PARK DR, 2ND FLOOR, LIVERPOOL, NY 13088-3589
(315) 434-9309
(315) 454-0136
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
154235
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01683467
—
NY
Enumeration date
08/22/2005
Last updated
09/13/2007
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