Provider Demographics
NPI:1093803835
Name:KALMAN, RYAN (PT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:KALMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST
Practice Address - Street 2:SUITE 33
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-526-9969
Practice Address - Fax:413-526-9960
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000035332OtherBOSTON MEDICAL HEALTH NET INDIVIDUAL NO.
MA043527497OtherAETNA GROUP NO.
MA043527497OtherCONNECTICARE
MAP00194754OtherPALMETTO RAILROAD MEDICARE
MA043527497OtherGREATWEST
MA28117OtherHEALTH NEW ENGLAND
MA690675OtherTUFTS GROUP NO.
MA0329819Medicaid
MA467738OtherTUFTS INDIVIDUAL NO.
MA972730OtherNETWORK HEALTH GROUP NO.
MA043527497OtherDEPARTMENT OF LABOR
MAY61264OtherBC BS GROUP NO.
MA043527497OtherPIONEER
MA11222892OtherCAQH
MAY67756OtherBC BS INDIVIDUAL NO.
MA000000035257OtherBOSTON MEDICAL HEALTH NET GROUP NO.
MA6118324OtherCIGNA INDIVIDUAL NO.
MA043527497OtherUNICARE/GIC
MA043527497OtherUNITED HEALTHCARE
MA043527497OtherCIGNA GROUP NO.
080011830MA01OtherANTHEM BC BS
MA7072252OtherAETNA INDIVIDUAL NO.
MA043527497OtherNORTH REGION/TRICARE
MA043527497OtherCONSOLIDATED
MA9715568Medicaid
MA043527497OtherGREATWEST
MA043527497OtherNORTH REGION/TRICARE