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General NPI Number Information
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NPI Number | 1952710808
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Entity Type | Organization
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Legal Business Name | CRRT, LLC
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 100 PLAINSBORO RD SUITE 1A
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City | PLAINSBORO
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State | NJ
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Zip | 08536-1914
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Country | US
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Telephone | 609-275-5550
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Fax | 609-599-2774
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Provider Business Mailing Address
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Address Line | 100 PLAINSBORO RD SUITE 1A
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City | PLAINSBORO
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State | NJ
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Zip | 08536-1914
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Country | US
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Telephone | 609-275-5550
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Fax | 609-599-2774
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. PHILIP GEORGE CALDERONE
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Credential | M.D.
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Telephone | 516-528-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 24952
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License Number State | NJ
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