Provider Demographics
NPI:1053372235
Name:CALIENDO, MARTIN JAMES (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:JAMES
Last Name:CALIENDO
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 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-344-4700
Mailing Address - Fax:585-344-5425
Practice Address - Street 1:33 CHANDLER AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1684
Practice Address - Country:US
Practice Address - Phone:585-344-4700
Practice Address - Fax:585-344-5425
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35304174400000X
TX43725207V00000X
NY282590207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36259OtherBLUECROSSBLUESHIELD
IA0422972Medicaid
IAI13030Medicare ID - Type Unspecified
IA36259OtherBLUECROSSBLUESHIELD