Provider Demographics
NPI:1831122571
Name:NORTH ARLINGTON PRIMARY CARE ASSOC.
Entity Type:Organization
Organization Name:NORTH ARLINGTON PRIMARY CARE ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALABRESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-955-0900
Mailing Address - Street 1:PO BOX 1939
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-1939
Mailing Address - Country:US
Mailing Address - Phone:973-743-2331
Mailing Address - Fax:973-743-1441
Practice Address - Street 1:25 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-5512
Practice Address - Country:US
Practice Address - Phone:201-955-0900
Practice Address - Fax:201-955-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ51087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0197761000OtherAMERIHEALTH
NJ2102200Medicaid
NJP00153380OtherRRMEDICARE
NJ107100Medicare PIN
NJ2102200Medicaid