Provider Demographics
NPI:1861484115
Name:CALVES, PEDRO H (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:H
Last Name:CALVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26A JOHN STREET
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702
Mailing Address - Country:US
Mailing Address - Phone:631-669-4500
Mailing Address - Fax:631-669-7710
Practice Address - Street 1:26A JOHN ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2905
Practice Address - Country:US
Practice Address - Phone:631-669-4500
Practice Address - Fax:631-669-7710
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167384207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01401261Medicaid
NYW88001Medicare ID - Type UnspecifiedGROUP #
NY12F641Medicare ID - Type UnspecifiedINDIV #
NY01401261Medicaid