Provider Demographics
NPI:1831123298
Name:CALABRO, LOUIS (PHD, ABPP)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:CALABRO
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12493-0309
Mailing Address - Country:US
Mailing Address - Phone:845-532-6419
Mailing Address - Fax:845-384-6482
Practice Address - Street 1:3642 MAIN ST
Practice Address - Street 2:
Practice Address - City:STONE RIDGE
Practice Address - State:NY
Practice Address - Zip Code:12484-5636
Practice Address - Country:US
Practice Address - Phone:845-532-6419
Practice Address - Fax:845-384-6482
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007483-1103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007483-1OtherNYS LICENSE # TO PRACTICE AS PSYCHOLOGISR