Provider Demographics
NPI:1326298951
Name:CALABRESE, MAUREEN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 MARCUS AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1017
Mailing Address - Country:US
Mailing Address - Phone:516-466-6611
Mailing Address - Fax:516-466-9582
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1017
Practice Address - Country:US
Practice Address - Phone:516-466-6611
Practice Address - Fax:516-466-9582
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304729363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health