Provider Demographics
NPI:1740502871
Name:SCALAMANDRE, MICHELE (RN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SCALAMANDRE
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 1:44 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2325
Mailing Address - Country:US
Mailing Address - Phone:631-642-7282
Mailing Address - Fax:
Practice Address - Street 1:44 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2325
Practice Address - Country:US
Practice Address - Phone:631-642-7282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY417811163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse