MEDICARE: DR. NEAL A CALABRESE IV D.C.

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	111N00000X	Chiropractor	38MC00798400	NJ

General Provider Information

NPI Number	:	1114606548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL A CALABRESE IV D.C.

Provider Business Mailing Address
First Line	:	179 VREELAND AVE
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2229
Country	:	US
Telephone Number	:	201-600-6124
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 SYLVAN ST STE 200
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2087
Country	:	US
Telephone Number	:	201-508-1996
Fax Number	:

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

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	08/08/2023

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