Healthcare Provider Details
I. General information
NPI: 1285634287
Provider Name (Legal Business Name): BRANCH BROOK HOSPITAL PHYSICIANS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 CLARA MAASS DRIVE
BELLEVILLE NJ
07109-3550
US
IV. Provider business mailing address
66 W GILBERT ST 2ND FLOOR
TINTON FALLS NJ
07701-4918
US
V. Phone/Fax
- Phone: 973-450-2000
- Fax:
- Phone: 732-212-0051
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
JOSEPH
JOHN
CALABRO
Title or Position: PRESIDENT
Credential: DO
Phone: 732-212-0060