Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 1968231 | NY |
N | 2080P0216X | Pediatric Rheumatologist | 1968231 | NY |
NPI | 1518928456 |
---|---|
Provider Name | Ms. Joan G Calkins |
First Address | Hamburg, NY 14075-6200 |
Second Address | Hamburg, NY 14075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01515782 | (05) | NY |
D68847 | (02) |