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General NPI Number Information
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NPI Number | 1164489621
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Entity Type | Organization
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Legal Business Name | SEACREST MEDICAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1160 RAYMOND BLVD
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City | NEWARK
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State | NJ
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Zip | 07102-4168
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Country | US
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Telephone | 973-596-3857
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Fax |
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST SUITE 100
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4918
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Country | US
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Telephone | 732-212-0060
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Fax | 732-212-0061
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH JOHN 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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NJ
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Taxonomy #4
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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 | NJ
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