Provider Demographics
NPI:1174138861
Name:MAURER, NICOLETTE (CT)
Entity type:Individual
Prefix:MRS
First Name:NICOLETTE
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:CT
Other - Prefix:MISS
Other - First Name:NICOLETTE
Other - Middle Name:
Other - Last Name:KALISZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CT
Mailing Address - Street 1:851 ORCHARDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5850
Mailing Address - Country:US
Mailing Address - Phone:216-903-1984
Mailing Address - Fax:
Practice Address - Street 1:851 ORCHARDVIEW RD
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-5850
Practice Address - Country:US
Practice Address - Phone:216-903-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH25646049207ZC0500X
OH16103207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology