Healthcare Provider Details

I. General information

NPI: 1972535904
Provider Name (Legal Business Name): MARILYN CAVEGLIA KALISH DR.P.H., APRN. BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 3RD ST
BEAVER PA
15009-2302
US

IV. Provider business mailing address

111 PATRICIA DR
BEAVER FALLS PA
15010-1126
US

V. Phone/Fax

Practice location:
  • Phone: 724-728-6670
  • Fax: 724-728-5570
Mailing address:
  • Phone: 724-843-0114
  • Fax: 724-728-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN113537L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: