Provider Demographics
NPI:1114352036
Name:CAVALUZZI, MELISSA
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:CAVALUZZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E HARTSDALE AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2743
Mailing Address - Country:US
Mailing Address - Phone:914-419-0817
Mailing Address - Fax:
Practice Address - Street 1:45 E HARTSDALE AVE
Practice Address - Street 2:APT 4C
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2743
Practice Address - Country:US
Practice Address - Phone:914-419-0817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1271110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist