Provider Demographics
NPI:1093789158
Name:CALDARELLA, FELICE A (MD)
Entity Type:Individual
Prefix:
First Name:FELICE
Middle Name:A
Last Name:CALDARELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 ROUTE 31 NORTH
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809
Mailing Address - Country:US
Mailing Address - Phone:908-735-3980
Mailing Address - Fax:908-735-3981
Practice Address - Street 1:1738 ROUTE 31 NORTH
Practice Address - Street 2:SUITE 108
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-735-3980
Practice Address - Fax:908-735-3981
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07212600207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0044458Medicaid
NJ0044458Medicaid
NJ070673Q3NMedicare ID - Type Unspecified