Provider Demographics
NPI:1093998452
Name:CALABRESE, SANDRA CHRISTINE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CHRISTINE
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LISO DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1917
Mailing Address - Country:US
Mailing Address - Phone:631-473-7327
Mailing Address - Fax:
Practice Address - Street 1:38 LISO DR
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1917
Practice Address - Country:US
Practice Address - Phone:631-473-7327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012092-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist