Healthcare Provider Details

I. General information

NPI: 1912417106
Provider Name (Legal Business Name): MIGUEL CALIMANO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 TERRY RD # 7
SMITHTOWN NY
11787-3811
US

IV. Provider business mailing address

88 TERRY RD # 7
SMITHTOWN NY
11787-3811
US

V. Phone/Fax

Practice location:
  • Phone: 631-926-5682
  • Fax: 631-406-7241
Mailing address:
  • Phone: 631-926-5682
  • Fax: 631-406-7241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number238218
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number238218
License Number StateNY

VIII. Authorized Official

Name: DR. MIGUEL CALIMANO
Title or Position: PRESIDENT
Credential: MD
Phone: 631-926-5692