Healthcare Provider Details
I. General information
NPI: 1831122571
Provider Name (Legal Business Name): NORTH ARLINGTON PRIMARY CARE ASSOC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 LOCUST AVE
NORTH ARLINGTON NJ
07031-5512
US
IV. Provider business mailing address
PO BOX 1939
BLOOMFIELD NJ
07003-1939
US
V. Phone/Fax
- Phone: 201-955-0900
- Fax: 201-955-7467
- Phone: 973-743-2331
- Fax: 973-743-1441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 51087 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
ANGELO
D
CALABRESE
Title or Position: OWNER
Credential: M.D.
Phone: 201-955-0900