Provider Demographics
NPI:1518928456
Name:CALKINS, JOAN G (MD)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:G
Last Name:CALKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17 LONG AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-6200
Mailing Address - Country:US
Mailing Address - Phone:716-646-5188
Mailing Address - Fax:716-646-5190
Practice Address - Street 1:17 LONG AVE
Practice Address - Street 2:STE 110
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075
Practice Address - Country:US
Practice Address - Phone:716-646-5188
Practice Address - Fax:716-646-5190
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1968231208000000X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01515782Medicaid
NYAA1033Medicare ID - Type Unspecified
NY01515782Medicaid