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NPI Code Detail

MEDICARE: MARCY CALSETTA

MEDICARE: MARCY CALSETTA
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
1363LF0000XFamily Nurse Practitioner7179CT

General Provider Information

NPI Number : 1184140394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCY CALSETTA
Provider Business Mailing Address
First Line : 30 JORDAN LN
Second Line :
City : WETHERSFIELD
State : CT
Zip : 06109-1278
Country : US
Telephone Number : 860-263-0253
Fax Number : 860-263-0262
Provider Business Practice Location Address
First Line : 925 SULLIVAN AVE
Second Line : STE 1
City : SOUTH WINDSOR
State : CT
Zip : 06074-2080
Country : US
Telephone Number : 860-644-1521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2017
Last Update Date : 02/09/2018

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