Healthcare Provider Details

I. General information

NPI: 1790727337
Provider Name (Legal Business Name): EPIFANIO CALCARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 ELMER ST
WESTFIELD NJ
07090-2128
US

IV. Provider business mailing address

552 WESTFIELD AVE
WESTFIELD NJ
07090-3312
US

V. Phone/Fax

Practice location:
  • Phone: 908-228-3675
  • Fax: 908-654-1053
Mailing address:
  • Phone: 908-654-3377
  • Fax: 908-789-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA44052
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: