Basic Information
Provider Information
NPI: 1285175687
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CALINI
FirstName: ROMAIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 37595 7 MILE RD STE 340
Address2:  
City: LIVONIA
State: MI
PostalCode: 481521003
CountryCode: US
TelephoneNumber: 7347932470
FaxNumber: 7347932471
Practice Location
Address1: 37595 7 MILE RD STE 340
Address2:  
City: LIVONIA
State: MI
PostalCode: 481521003
CountryCode: US
TelephoneNumber: 7347932470
FaxNumber: 7347932471
Other Information
ProviderEnumerationDate: 03/17/2017
LastUpdateDate: 10/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X306358NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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