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NPI Code Detail

MEDICARE: LIBERTY MED ASSOCIATES LLC

MEDICARE: LIBERTY MED ASSOCIATES LLC
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
1213ES0103XFoot & Ankle Surgery Podiatrist

General Provider Information

NPI Number : 1386279552
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY MED ASSOCIATES LLC
Provider Business Mailing Address
First Line : 66 W GILBERT ST
Second Line :
City : TINTON FALLS
State : NJ
Zip : 07701-4947
Country : US
Telephone Number : 732-936-6463
Fax Number :
Provider Business Practice Location Address
First Line : 1 BETHANY RD STE 21
Second Line :
City : HAZLET
State : NJ
Zip : 07730-1660
Country : US
Telephone Number : 732-264-8282
Fax Number :
Authorized Official
Title or Position : CEO
Name : JOSEPH JOHN CALABRO
Credential : DO
Telephone Number : 732-212-0051
Provider Enumeration Date : 03/09/2020
Last Update Date : 03/09/2020

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Directions to “LIBERTY MED ASSOCIATES LLC ” Practice Location

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