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General NPI Number Information
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NPI Number | 1093190704
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Entity Type | Organization
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Legal Business Name | PHYSICIAN AT NEWBURGH
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 396 BROADWAY
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City | KINGSTON
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State | NY
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Zip | 12401-4626
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Country | US
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Telephone | 845-331-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST 2ND FLOOR
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4947
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Country | US
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Telephone | 732-212-0060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH J CALABRO
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Credential | DO
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Telephone | 732-212-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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