Provider Demographics
NPI:1629877014
Name:MAI, CALVIN B (PHARMD)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:B
Last Name:MAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ALTAVISTA CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-5113
Mailing Address - Country:US
Mailing Address - Phone:718-663-9977
Mailing Address - Fax:
Practice Address - Street 1:37 ALTAVISTA CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-5113
Practice Address - Country:US
Practice Address - Phone:718-663-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03259100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty