Provider Demographics
NPI:1659555977
Name:CALABRESE, MICHELLE NICOLE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NICOLE
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 COUNTY ROUTE 64
Mailing Address - Street 2:BUILDING #2
Mailing Address - City:BIG FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:14903
Mailing Address - Country:US
Mailing Address - Phone:607-739-6103
Mailing Address - Fax:607-739-5674
Practice Address - Street 1:830 COUNTY ROUTE 64
Practice Address - Street 2:BUILDING #2
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14903
Practice Address - Country:US
Practice Address - Phone:607-739-6103
Practice Address - Fax:607-739-5674
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist