Provider Demographics
NPI:1881636157
Name:CALDERA, AURA (MD)
Entity Type:Individual
Prefix:DR
First Name:AURA
Middle Name:
Last Name:CALDERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 20 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2834
Mailing Address - Country:US
Mailing Address - Phone:718-641-8207
Mailing Address - Fax:
Practice Address - Street 1:94 07 60 TH AVENUE
Practice Address - Street 2:D3
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5069
Practice Address - Country:US
Practice Address - Phone:718-271-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151898208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420828Medicaid
NYC07739Medicare UPIN