Healthcare Provider Details

I. General information

NPI: 1023341872
Provider Name (Legal Business Name): ROSA CALDERON SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BROADWAY
PASSAIC NJ
07055-5007
US

IV. Provider business mailing address

7000 KENNEDY BLVD E APT 45A
WEST NEW YORK NJ
07093-4869
US

V. Phone/Fax

Practice location:
  • Phone: 201-598-1110
  • Fax: 201-227-9509
Mailing address:
  • Phone: 201-598-1110
  • Fax: 201-227-9509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07841700
License Number StateNJ

VIII. Authorized Official

Name: DR. ROSA CALDERON
Title or Position: PRINCIPAL
Credential: M.D.
Phone: 201-598-1110