Provider Demographics
NPI:1750884805
Name:FOX, DANA CALABRESE (FNP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:CALABRESE
Last Name:FOX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MEDICAL PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-5050
Mailing Address - Country:US
Mailing Address - Phone:518-289-2775
Mailing Address - Fax:
Practice Address - Street 1:8 MEDICAL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-5050
Practice Address - Country:US
Practice Address - Phone:518-289-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342695-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner