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General NPI Number Information
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NPI Number | 1518108125
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSOCIATES OF TEANECK, P.A.
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 718 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST
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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 | 732-212-0713
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Authorized Official
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Title or Position | PRESIDENT
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Name | 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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