Provider Demographics
NPI:1740562842
Name:CALEV, CAROL JOAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JOAN
Last Name:CALEV
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9 DUCHARME LN
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1612
Mailing Address - Country:US
Mailing Address - Phone:631-754-5400
Mailing Address - Fax:631-754-5412
Practice Address - Street 1:625 PULASKI RD
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1716
Practice Address - Country:US
Practice Address - Phone:631-754-5400
Practice Address - Fax:631-754-5412
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY267151-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse