Provider Demographics
NPI:1306106513
Name:CALVARESI, ANNE (CRNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:CALVARESI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:LIZARDI-CALVARESI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:215-955-1000
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST
Practice Address - Street 2:SUITE 703
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4414
Practice Address - Country:US
Practice Address - Phone:215-955-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103015879Medicaid
PA244845Medicare PIN