Healthcare Provider Details

I. General information

NPI: 1003817933
Provider Name (Legal Business Name): PPE-KEYSTONE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LINCOLN AVE
CARBONDALE PA
18407-2170
US

IV. Provider business mailing address

66 W GILBERT ST 2ND FLOOR
TINTON FALLS NJ
07701-4918
US

V. Phone/Fax

Practice location:
  • Phone: 570-281-1004
  • Fax:
Mailing address:
  • Phone: 732-212-0051
  • Fax: 732-212-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StatePA

VIII. Authorized Official

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