Provider Demographics
NPI:1811093255
Name:CALIN, CRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CALIN
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 1:136 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3451
Mailing Address - Country:US
Mailing Address - Phone:860-200-4305
Mailing Address - Fax:
Practice Address - Street 1:136 S MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3451
Practice Address - Country:US
Practice Address - Phone:860-200-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73829207Q00000X
ND10175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13858Medicaid
ND13858Medicaid
NDI67293Medicare UPIN