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Individual

CALVIN DYMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA-C

Contact information

Practice address
95 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-7001
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
010264
NY
363AM0700X
Medical Physician Assistant
010264
NY
363AS0400X
Surgical Physician Assistant
Primary
010264
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02650764
NY
Enumeration date
10/14/2005
Last updated
11/17/2009
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