Provider Demographics
NPI:1285716555
Name:KALIKA, VLADIMIR (DO)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:KALIKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 E 68TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6011
Mailing Address - Country:US
Mailing Address - Phone:718-282-0900
Mailing Address - Fax:718-282-0995
Practice Address - Street 1:800 CORTELYOU RD
Practice Address - Street 2:STE 1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5243
Practice Address - Country:US
Practice Address - Phone:718-282-0900
Practice Address - Fax:718-282-0995
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212836207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H15083Medicare UPIN