Provider Demographics
NPI:1700951167
Name:CALVANESE, ALPHONSE F (MD)
Entity Type:Individual
Prefix:
First Name:ALPHONSE
Middle Name:F
Last Name:CALVANESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:299 CAREW STREET
Mailing Address - Street 2:SUITE 426
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2363
Mailing Address - Country:US
Mailing Address - Phone:413-732-8060
Mailing Address - Fax:413-732-1018
Practice Address - Street 1:299 CAREW STREET
Practice Address - Street 2:SUITE 426
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2363
Practice Address - Country:US
Practice Address - Phone:413-732-8060
Practice Address - Fax:413-732-1018
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA44981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH11017OtherBCBS
731790OtherTUFTS
H11017Medicare ID - Type Unspecified
MAH11017OtherBCBS