Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 044775 | NY |
NPI | 1063597433 |
---|---|
Provider Name | Dr. Paul G. Calabrese |
First Address | Orchard Park, NY 14127-2641 |
Second Address | Orchard Park, NY 14127-2641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |