Organization
CHARLES J.KALLICK, M.D.,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOHN KALLICK M.D. (PRESIDENT)
(203) 226-3685
Entity
Organization
Contact information
Practice address
12 CROOKED MILE RD, WESTPORT, CT 06880-1123
(203) 226-3685
Mailing address
12 CROOKED MILE RD, WESTPORT, CT 06880-1123
(203) 226-3685
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
011345
CT
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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