=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629218359
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TEANECK HOSPITALISTS, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2009
-----------------------------------------------------
Last Update Date | 05/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 718 TEANECK RD
-----------------------------------------------------
City | TEANECK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07666-4245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-833-3000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 66 WEST GILBERT STREET
-----------------------------------------------------
City | RED BANK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-212-0051
-----------------------------------------------------
Fax | 732-212-0713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOSEPH J CALABRO
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 732-212-0051
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------