Provider Demographics
NPI:1487630232
Name:CALABRESE, CHRISTINE J (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:J
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:J
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:GROVE HILL MEDICAL CENTER
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-224-6249
Mailing Address - Fax:860-224-6241
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-224-6249
Practice Address - Fax:860-224-6241
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002568363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004224846Medicaid
CTP3174405OtherOXFORD
CT2V7696OtherHEALTH NET
CT400002568CT04OtherBCBS ID
CT1255448155OtherGHMC GROUP NPI
CT400002568CT04OtherBCFP MEDICAID
CT004221959Medicaid
CT0256801190OtherCONNECTICARE
CT370368OtherWELLCARE MEDICARE
CTC01373Medicare ID - Type UnspecifiedGHMC GROUP MEDICARE ID
CT2V7696OtherHEALTH NET
CT400002568CT04OtherBCFP MEDICAID