Provider Demographics
NPI:1972535904
Name:KALISH, MARILYN CAVEGLIA (DRPH, APRN BC)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:CAVEGLIA
Last Name:KALISH
Suffix:
Gender:F
Credentials:DRPH, APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1126
Mailing Address - Country:US
Mailing Address - Phone:724-843-0114
Mailing Address - Fax:724-728-5570
Practice Address - Street 1:337 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2302
Practice Address - Country:US
Practice Address - Phone:724-728-6670
Practice Address - Fax:724-728-5570
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN113537L163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA294586A169606Medicaid
PAKA1784465OtherHIGHMARK BLUE SHIELD
PAKA1784465OtherHIGHMARK BLUE SHIELD
PA294586A169606Medicaid