Healthcare Provider Details

I. General information

NPI: 1407624414
Provider Name (Legal Business Name): JAY CALDERARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 RIVER ST STE 9
HOBOKEN NJ
07030-5990
US

IV. Provider business mailing address

1345 S OLDEN AVE
HAMILTON NJ
08610-2923
US

V. Phone/Fax

Practice location:
  • Phone: 732-314-3475
  • Fax:
Mailing address:
  • Phone: 732-425-6112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06497000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: