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Contact Information

STACI M KALLISH, DO
3400 CIVIC CENTER BLVD.
1ST FLOOR
PHILADELPHIA, PA19104
 Phone: 215-662-2454
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Genetics (M.D.)

207SG0201X
 

Clinical Biochemical Genetics

207SG0202X
Indicates primary specialty

NPI Profile & details for STACI M KALLISH · (Female)

NPI # 1811152796
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/21/2008
Last updated 09/13/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • PA License # OS014273
Hospital affiliation(s)
  • HOSPITAL OF UNIV OF PENNSYLVANIA - (Acute Care)
    34TH & SPRUCE STS
    PHILADELPHIA, PA 19104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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