Provider Demographics
NPI:1386722700
Name:CALCATTI, JAVID A (MD)
Entity type:Individual
Prefix:DR
First Name:JAVID
Middle Name:A
Last Name:CALCATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 MINERAL SPRING AVE STE 203
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4025
Mailing Address - Country:US
Mailing Address - Phone:401-438-1010
Mailing Address - Fax:
Practice Address - Street 1:1635 MINERAL SPRING AVE STE 203
Practice Address - Street 2:SUITE 305
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4025
Practice Address - Country:US
Practice Address - Phone:401-438-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI408256OtherBLUE CHIP
RI029762OtherBLUE CROSS BLUE SHIELD
RIH32399Medicare UPIN
RI119003859Medicare PIN