MEDICARE: DR. MICHAEL JOSEPH CALARCO 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	DC010464	PA
2	111N00000X	Chiropractor	X012053-1	NY

General Provider Information

NPI Number	:	1811217581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOSEPH CALARCO D.C.

Provider Business Mailing Address
First Line	:	101 LANG BLVD
Second Line	:
City	:	GRAND ISLAND
State	:	NY
Zip	:	14072-1601
Country	:	US
Telephone Number	:	716-799-4582
Fax Number	:	716-774-8004

Provider Business Practice Location Address
First Line	:	101 LANG BLVD
Second Line	:
City	:	GRAND ISLAND
State	:	NY
Zip	:	14072-1601
Country	:	US
Telephone Number	:	716-799-4582
Fax Number	:	716-774-8004

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

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	06/24/2019

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