Provider Demographics
NPI:1033920905
Name:CALVO, ANTHONY JOHN (PA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOHN
Last Name:CALVO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1632
Mailing Address - Country:US
Mailing Address - Phone:631-513-2423
Mailing Address - Fax:
Practice Address - Street 1:43 S PARK DR
Practice Address - Street 2:
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804-1632
Practice Address - Country:US
Practice Address - Phone:631-513-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant