Provider Demographics
NPI:1134295173
Name:CALAMIA, RAFAELE T (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RAFAELE
Middle Name:T
Last Name:CALAMIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S BRYN MAWR AVE
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3120
Mailing Address - Country:US
Mailing Address - Phone:610-525-7800
Mailing Address - Fax:610-525-7801
Practice Address - Street 1:101 S BRYN MAWR AVE
Practice Address - Street 2:SUITE 300A
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3120
Practice Address - Country:US
Practice Address - Phone:610-525-7800
Practice Address - Fax:610-525-7801
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACA-AP2409363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACA-AP2409Medicare ID - Type Unspecified