Basic Information
| Provider Information | |||||||||
| NPI: | 1174594055 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAISER | ||||||||
| FirstName: | ALLAN | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 GREENWOOD AVE. | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188719191 | ||||||||
| FaxNumber: | 7184386006 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 GREENWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112181340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188719191 | ||||||||
| FaxNumber: | 7184386006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 02/26/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 106047 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.