Provider Demographics
NPI:1134673510
Name:CALISE, NOEL
Entity Type:Individual
Prefix:MRS
First Name:NOEL
Middle Name:
Last Name:CALISE
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:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:NY
Mailing Address - Zip Code:11948-0004
Mailing Address - Country:US
Mailing Address - Phone:631-298-1104
Mailing Address - Fax:
Practice Address - Street 1:41 YAPHANK MIDDLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-2369
Practice Address - Country:US
Practice Address - Phone:631-345-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014420-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist