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General NPI Number Information
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NPI Number | 1710394127
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Entity Type | Individual
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Provider Name | DIANA CALLESANO AU.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 113 CROSSWAYS PARK DR SUITE 101
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City | WOODBURY
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State | NY
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Zip | 11797-2044
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Country | US
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Telephone | 516-364-0011
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Fax | 516-364-0013
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Provider Business Mailing Address
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Address Line | 113 CROSSWAYS PARK DR SUITE 101
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City | WOODBURY
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State | NY
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Zip | 11797-2044
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Country | US
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Telephone | 516-364-0011
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Fax | 516-364-0013
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 002531
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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