MEDICARE: DR. MICHAEL FRED CALABRESE DC

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	111N00000X	Chiropractor	X0101485-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1447318084	OTHER		NPI

General Provider Information

NPI Number	:	1447318084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL FRED CALABRESE DC

Provider Business Mailing Address
First Line	:	139 E 57TH ST
Second Line	:	FL 8
City	:	NEW YORK
State	:	NY
Zip	:	10022-2102
Country	:	US
Telephone Number	:	212-750-5088
Fax Number	:	212-750-6118

Provider Business Practice Location Address
First Line	:	139 E 57TH ST
Second Line	:	FL 8
City	:	NEW YORK
State	:	NY
Zip	:	10022-2102
Country	:	US
Telephone Number	:	212-750-5088
Fax Number	:	212-750-6118

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	02/03/2021

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