Provider Demographics
NPI:1629223094
Name:CALANDRIELLO, PATRICIA O (PT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:O
Last Name:CALANDRIELLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1054
Mailing Address - Country:US
Mailing Address - Phone:732-571-3106
Mailing Address - Fax:
Practice Address - Street 1:232 NORWOOD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1859
Practice Address - Country:US
Practice Address - Phone:732-923-1500
Practice Address - Fax:732-923-1510
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00827200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist