Healthcare Provider Details

I. General information

NPI: 1457354060
Provider Name (Legal Business Name): BRIAN CALABRESE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 ROUTE 70 E STE E125
MARLTON NJ
08053-2364
US

IV. Provider business mailing address

773 ROUTE 70 E STE E125
MARLTON NJ
08053-2364
US

V. Phone/Fax

Practice location:
  • Phone: 856-890-7200
  • Fax: 856-872-7636
Mailing address:
  • Phone: 856-890-7200
  • Fax: 856-872-7636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number34C.000835
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberOS012014
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: