Healthcare Provider Details

I. General information

NPI: 1386569408
Provider Name (Legal Business Name): ANDREA CALABRO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 PALMER AVE
MAYWOOD NJ
07607-1519
US

IV. Provider business mailing address

633 PALMER AVE
MAYWOOD NJ
07607-1519
US

V. Phone/Fax

Practice location:
  • Phone: 551-486-6677
  • Fax:
Mailing address:
  • Phone: 551-486-6677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number40QA00647700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: