MEDICARE: DR. LOUIS THOMAS CALVANO D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X004585	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0098802	OTHER	NY	GHI PROVIDER ID
2	P413800	OTHER	NY	OXFORD HEALTH PLANS PROVI

General Provider Information

NPI Number	:	1790844504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS THOMAS CALVANO D.C.

Provider Business Mailing Address
First Line	:	470 PARK AVE S
Second Line	:	FRONT 2
City	:	NEW YORK
State	:	NY
Zip	:	10016-6819
Country	:	US
Telephone Number	:	212-369-5490
Fax Number	:	212-685-6605

Provider Business Practice Location Address
First Line	:	470 PARK AVE S
Second Line	:	FRONT 2
City	:	NEW YORK
State	:	NY
Zip	:	10016-6819
Country	:	US
Telephone Number	:	212-369-5490
Fax Number	:	212-685-6605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	10/15/2016

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Directions to “ DR. LOUIS THOMAS CALVANO D.C.” Practice Location

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