Provider Demographics
NPI:1720526999
Name:KALTER PHYSICAL MEDICINE & REHABILITATION PC
Entity type:Organization
Organization Name:KALTER PHYSICAL MEDICINE & REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-361-5300
Mailing Address - Street 1:496 SMITHTOWN BYP
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5005
Mailing Address - Country:US
Mailing Address - Phone:631-361-5300
Mailing Address - Fax:631-361-5301
Practice Address - Street 1:496 SMITHTOWN BYP
Practice Address - Street 2:SUITE 200
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5005
Practice Address - Country:US
Practice Address - Phone:631-361-5300
Practice Address - Fax:631-361-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2383072081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty