MEDICARE: MICHELLE RYAN CALIFANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	014230	NY
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164778288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE RYAN CALIFANO

Provider Business Mailing Address
First Line	:	139 CORNELL ST
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-3633
Country	:	US
Telephone Number	:	845-338-1234
Fax Number	:	845-338-6284

Provider Business Practice Location Address
First Line	:	334 HIBERNIA RD
Second Line	:
City	:	SALT POINT
State	:	NY
Zip	:	12578-2133
Country	:	US
Telephone Number	:	845-464-5933
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	08/26/2024

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Directions to “ MICHELLE RYAN CALIFANO ” Practice Location

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