Provider Demographics
NPI:1922437979
Name:MACALUSO, JEFFREY
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:MACALUSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ROSELAND AVE
Mailing Address - Street 2:APT 35
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5964
Mailing Address - Country:US
Mailing Address - Phone:315-651-0153
Mailing Address - Fax:
Practice Address - Street 1:155 ROSELAND AVE
Practice Address - Street 2:APT 35
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5964
Practice Address - Country:US
Practice Address - Phone:315-651-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0537301835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist