Provider Demographics
NPI:1730695818
Name:CALCANO, DOMILKA PAOLA
Entity type:Individual
Prefix:
First Name:DOMILKA
Middle Name:PAOLA
Last Name:CALCANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 PELHAM ST APT 13
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2039
Mailing Address - Country:US
Mailing Address - Phone:978-398-2923
Mailing Address - Fax:
Practice Address - Street 1:134 PELHAM ST APT 13
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2039
Practice Address - Country:US
Practice Address - Phone:978-398-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program