Provider Demographics
NPI:1821313891
Name:CAVALLA, VERONICA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:ANN
Last Name:CAVALLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JEFFERSON PLZ FL 4
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4057
Mailing Address - Country:US
Mailing Address - Phone:845-483-3552
Mailing Address - Fax:845-483-3597
Practice Address - Street 1:4 JEFFERSON PLZ FL 4
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4057
Practice Address - Country:US
Practice Address - Phone:845-483-3552
Practice Address - Fax:845-483-3597
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213365163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult