Provider Demographics
NPI:1104897123
Name:CALIENDO, MARK V (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:V
Last Name:CALIENDO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:140 BROOKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-9505
Mailing Address - Country:US
Mailing Address - Phone:570-943-2769
Mailing Address - Fax:570-213-7936
Practice Address - Street 1:140 BROOKSHIRE LN
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9505
Practice Address - Country:US
Practice Address - Phone:570-213-7932
Practice Address - Fax:570-213-7936
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2011-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4180192085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018654510004Medicaid
PA50000691OtherCAPITAL BLUE CROSS
PA70465OtherGEISINGER HEALTH PLAN
PA940000266OtherRAILROAD MEDICARE
PA101329OtherFEDERAL BLACK LUNG
PA1328834OtherHIGHMARK BLUE SHIELD
PA054873Medicare ID - Type Unspecified
PA0018654510004Medicaid