Individual
CAROLINA MCCALMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 ROUTE 112 STE 101, PORT JEFFERSON STATION, NY 11776-8054
(631) 751-3000
(631) 509-6559
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-7500
(910) 662-7501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-12197
NC
363A00000X
Physician Assistant
Primary
020768
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013935600
—
FL
01
—
P01409146
RAILROAD MEDICARE
FL
Enumeration date
12/03/2014
Last updated
06/29/2022
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