Provider Demographics
NPI:1790844504
Name:CALVANO, LOUIS THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:THOMAS
Last Name:CALVANO
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 1:470 PARK AVE S
Mailing Address - Street 2:FRONT 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6819
Mailing Address - Country:US
Mailing Address - Phone:212-369-5490
Mailing Address - Fax:212-685-6605
Practice Address - Street 1:470 PARK AVE S
Practice Address - Street 2:FRONT 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6819
Practice Address - Country:US
Practice Address - Phone:212-369-5490
Practice Address - Fax:212-685-6605
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0098802OtherGHI PROVIDER ID
NYP413800OtherOXFORD HEALTH PLANS PROVI
NYX34991Medicare PIN
NYP413800OtherOXFORD HEALTH PLANS PROVI