Provider Demographics
NPI:1700853835
Name:CALDIERO, PETER JOSEPH (DPT)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:CALDIERO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PHEASANT FIELD LN
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1430
Mailing Address - Country:US
Mailing Address - Phone:856-665-0830
Mailing Address - Fax:856-424-0994
Practice Address - Street 1:1919 GREENTREE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:856-424-0993
Practice Address - Fax:856-424-0994
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01162200225100000X
PAPT017064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096879Medicare ID - Type Unspecified