Healthcare Provider Details

I. General information

NPI: 1164489621
Provider Name (Legal Business Name): SEACREST MEDICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 RAYMOND BLVD
NEWARK NJ
07102-4168
US

IV. Provider business mailing address

66 W GILBERT ST SUITE 100
TINTON FALLS NJ
07701-4918
US

V. Phone/Fax

Practice location:
  • Phone: 973-596-3857
  • Fax:
Mailing address:
  • Phone: 732-212-0060
  • Fax: 732-212-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. JOSEPH JOHN CALABRO
Title or Position: PRESIDENT
Credential: DO
Phone: 732-212-0060