Provider Demographics
NPI:1619374824
Name:MCCALMON, CAROLINA (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:MCCALMON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:REMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-7500
Mailing Address - Fax:910-662-7501
Practice Address - Street 1:1500 ROUTE 112 STE 101
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-8054
Practice Address - Country:US
Practice Address - Phone:631-751-3000
Practice Address - Fax:631-509-6559
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12197363A00000X
NY020768363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013935600Medicaid
FLP01409146OtherRAILROAD MEDICARE
FLP01409146OtherRAILROAD MEDICARE