Provider Demographics
NPI:1083976310
Name:CALECA, NANCY (MSED)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:CALECA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 AUBURN AVE
Mailing Address - Street 2:APT. C
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1800
Mailing Address - Country:US
Mailing Address - Phone:917-822-3174
Mailing Address - Fax:917-822-3174
Practice Address - Street 1:171 AUBURN AVE
Practice Address - Street 2:APT. C
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1800
Practice Address - Country:US
Practice Address - Phone:917-822-3174
Practice Address - Fax:917-822-3174
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1806993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist