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General NPI Number Information
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NPI Number | 1174633903
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Entity Type | Individual
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Provider Name | KATHRYN ELISE CALABRIA D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 1101 STEWART AVE SUITE 1ES
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City | GARDEN CITY
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State | NY
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Zip | 11530-4892
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Country | US
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Telephone | 631-776-0432
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Fax | 516-227-5373
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Provider Business Mailing Address
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Address Line | 2797 MONTAUK HWY
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City | BROOKHAVEN
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State | NY
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Zip | 11719-9596
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Country | US
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Telephone | 631-776-0432
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Fax | 631-803-6064
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | A169270
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License Number State | NY
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