Provider Demographics
NPI:1538136270
Name:CALCAGNO, JOSEPH R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:CALCAGNO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1409
Mailing Address - Country:US
Mailing Address - Phone:724-274-6664
Mailing Address - Fax:724-274-0600
Practice Address - Street 1:541 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:PA
Practice Address - Zip Code:15144-1409
Practice Address - Country:US
Practice Address - Phone:724-274-6664
Practice Address - Fax:724-274-0600
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002120L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019107290001Medicaid
PA1019107290001Medicaid
PAT29801Medicare UPIN