Provider Demographics
NPI:1558597096
Name:GEMME, LARISSA ANN CALKA (DO)
Entity Type:Individual
Prefix:DR
First Name:LARISSA
Middle Name:ANN CALKA
Last Name:GEMME
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LARISSA
Other - Middle Name:ANN
Other - Last Name:CALKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:900 CUMMINGS CENTER
Mailing Address - Street 2:SUITE 107T
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-922-0357
Mailing Address - Fax:978-922-1105
Practice Address - Street 1:900 CUMMINGS CENTER
Practice Address - Street 2:SUITE 107T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-922-0357
Practice Address - Fax:978-922-1105
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250205207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM