Provider Demographics
NPI:1316197239
Name:CALPIN, MARY ELLEN (LCAT, MT-BC)
Entity Type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:CALPIN
Suffix:
Gender:F
Credentials:LCAT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2487 W CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NEWFANE
Mailing Address - State:NY
Mailing Address - Zip Code:14108-9749
Mailing Address - Country:US
Mailing Address - Phone:716-778-6811
Mailing Address - Fax:
Practice Address - Street 1:2487 W CREEK RD
Practice Address - Street 2:
Practice Address - City:NEWFANE
Practice Address - State:NY
Practice Address - Zip Code:14108-9749
Practice Address - Country:US
Practice Address - Phone:716-778-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-28
Last Update Date:2008-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000060225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist