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General NPI Number Information
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NPI Number | 1881994994
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Entity Type | Organization
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Legal Business Name | VINCENTE CALDERON OD PC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 2799 ELM ST
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City | OCEANSIDE
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State | NY
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Zip | 11572-1914
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Country | US
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Telephone | 347-821-9748
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Fax |
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Provider Business Mailing Address
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Address Line | 2742A E TREMONT AVE
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City | BRONX
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State | NY
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Zip | 10461-2808
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Country | US
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Telephone | 347-709-3393
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. VINCENTE ANTHONY CALDERON
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Credential | O.D.
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Telephone | 347-709-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 007143
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License Number State | NY
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