MEDICARE: INTEGRITY HEALTH 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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1992101067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY HEALTH LLC

Provider Business Mailing Address
First Line	:	404 INDIANA AVE
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-6122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 INDIANA AVE
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-6122
Country	:	US
Telephone Number	:	732-212-0060
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH CALABRO
Credential	:	DO
Telephone Number	:	732-212-0061

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	01/26/2015

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