MEDICARE: MISS ANNE MARIE CALVELLO PA-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	363A00000X	Physician Assistant	MA056545	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982031092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANNE MARIE CALVELLO PA-C

Provider Business Mailing Address
First Line	:	1030 NEW HOLLAND AVE
Second Line	:	BLDG 12A SUITE 200
City	:	LANCASTER
State	:	PA
Zip	:	17604-5690
Country	:	US
Telephone Number	:	717-544-5028
Fax Number	:	717-544-4296

Provider Business Practice Location Address
First Line	:	2102 HARRISBURG PIKE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2644
Country	:	US
Telephone Number	:	717-544-9400
Fax Number	:	717-544-9401

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

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	04/24/2018

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