Provider Demographics
NPI:1285634287
Name:BRANCH BROOK HOSPITAL PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:BRANCH BROOK HOSPITAL PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CALABRO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-212-0060
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4918
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:
Practice Address - Street 1:1 CLARA MAASS DRIVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2344649000OtherAMERIHEALTH
NJ60011643OtherHORIZON NJ HEALTH
NJ0052426Medicaid
NJDC7529OtherRAILROAD MEDICARE
NJDC7526OtherRAILROAD MEDICARE
NJDC7529OtherRAILROAD MEDICARE
NJ086773Medicare PIN