Healthcare Provider Details
I. General information
NPI: 1689355661
Provider Name (Legal Business Name): HTDOCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 HORIZON CENTER BLVD
HAMILTON NJ
08691
US
IV. Provider business mailing address
66 W GILBERT ST
TINTON FALLS NJ
07701-4947
US
V. Phone/Fax
- Phone: 732-212-0060
- Fax:
- Phone: 732-212-0060
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
CALABRO
Title or Position: OWNER
Credential: DO
Phone: 732-212-0060