Provider Demographics
NPI:1164409991
Name:MICHAEL D. CALABRESE, PHYSICIAN P. C.
Entity Type:Organization
Organization Name:MICHAEL D. CALABRESE, PHYSICIAN P. C.
Other - Org Name:MEDICAL CARE OF WNY AT BUFFALO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALABRESE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:716-883-0515
Mailing Address - Street 1:656 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1836
Mailing Address - Country:US
Mailing Address - Phone:716-883-0515
Mailing Address - Fax:716-883-8764
Practice Address - Street 1:656 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1836
Practice Address - Country:US
Practice Address - Phone:716-883-0515
Practice Address - Fax:716-883-8764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6001005OtherBCBS
NYPA1595OtherMEDICARE PTAN
NY02345059Medicaid
NY02810800Medicaid
NY02849498Medicaid
NY00839318Medicaid
NYPA1595OtherMEDICARE PTAN
NY02849498Medicaid
NY00481136Medicaid
NYB71063Medicare UPIN
NYQ76355Medicare UPIN
NYE15442Medicare UPIN
NY02345059Medicaid
NYRB3586Medicare PIN
NYPA1595OtherMEDICARE PTAN
NY00839318Medicaid
NYRA2344Medicare PIN