Provider Demographics
NPI:1356510994
Name:CALVEY, KEVIN P (PT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:CALVEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 TESTAVERDE RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4859
Mailing Address - Country:US
Mailing Address - Phone:302-545-3987
Mailing Address - Fax:
Practice Address - Street 1:832 KOHL AVE
Practice Address - Street 2:HEDGELAWN PLAZA
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-545-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10002309225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356510994OtherCHAMPUS TRICARE
DE1356510994Medicaid
3499701000OtherIBC
11891511OtherCAQH
3499701000OtherIBC
11891511OtherCAQH