Provider Demographics
NPI:1154985513
Name:MACALUSO, TAYLOR ANNE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:MACALUSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ELLIOT ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-2035
Mailing Address - Country:US
Mailing Address - Phone:631-804-1349
Mailing Address - Fax:
Practice Address - Street 1:65 ELLIOT ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-2035
Practice Address - Country:US
Practice Address - Phone:631-804-1349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency