Provider Demographics
NPI:1043579006
Name:CALABRESE, JOHN FELIX (BC-HIS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FELIX
Last Name:CALABRESE
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5206
Mailing Address - Country:US
Mailing Address - Phone:608-249-3791
Mailing Address - Fax:
Practice Address - Street 1:2040 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5206
Practice Address - Country:US
Practice Address - Phone:608-249-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI550237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist