Provider Demographics
NPI:1891722237
Name:CALABRESE, ANGELO D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:D
Last Name:CALABRESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ51087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0197761000OtherAMERIHEALTH
NJP00153380OtherRAILROAD MEDICARE
NJ2102200Medicaid
NJE13138Medicare UPIN
NJP00153380OtherRAILROAD MEDICARE