Provider Demographics
NPI:1861565913
Name:CHARLES C CALENDA MD INC
Entity type:Organization
Organization Name:CHARLES C CALENDA MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:CALENDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-245-3937
Mailing Address - Street 1:639 METACOM AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-2348
Mailing Address - Country:US
Mailing Address - Phone:401-245-3937
Mailing Address - Fax:401-245-8657
Practice Address - Street 1:639 METACOM AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-2348
Practice Address - Country:US
Practice Address - Phone:401-245-3937
Practice Address - Fax:401-245-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0605207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0210360002Medicare NSC
RI0210360001Medicare NSC