MEDICARE: MAE HELEN CALEB M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD036970L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023070240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAE HELEN CALEB M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 5020
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08754-5020
Country	:	US
Telephone Number	:	800-528-0006
Fax Number	:	732-349-6030

Provider Business Practice Location Address
First Line	:	5800 RIDGE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128
Country	:	US
Telephone Number	:	215-487-4334
Fax Number	:	610-891-3680

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	01/24/2011

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