Mballu P Kallon, RN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2947931 Issued in NY

Practice address

1322 Clay Ave
Bronx, NY 10456-1766

Phone

(646) 915-4666

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1962787291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRAND CONCOURSE APT 1F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575214",
            "telephone_number": "347-399-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 CLAY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104561766",
            "telephone_number": "646-915-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "998 Crooked Hill Rd",
            "address_purpose": "LOCATION",
            "city": "West Brentwood",
            "state": "NY",
            "postal_code": "117171019",
            "country_code": "US",
            "telephone_number": "631-761-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLON",
        "first_name": "MBALLU",
        "middle_name": "P",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "758198",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2947931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kezely Kalivogui
• Gary E Kalkut, MD
• Mohammed Kallash, MD
• Stavroula Kallinikos
• Alhaji Kallon
• Alaa Kalloub, M.D.
• Deepti Kalluri, M.D.
• Anantha P Kallury, RPH
• Shana Brooke Kalman
• Aleksander Kalmus, DC AS DOCTOR OF CHIR

• Licensed Practical Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.