Provider Demographics
NPI:1972504413
Name:CALABRO, JOSEPH JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:CALABRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4918
Mailing Address - Country:US
Mailing Address - Phone:732-212-0060
Mailing Address - Fax:732-212-0061
Practice Address - Street 1:268 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2011
Practice Address - Country:US
Practice Address - Phone:973-877-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004892L207P00000X
NJ25MB05431100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814102OtherFIRST PRIORITY HEALTH
PA677829OtherBLUE SHIELD
PA001245779Medicaid
NJ5009707Medicaid
NJ5009707Medicaid
NJ609427UXLMedicare PIN
NJ609427DLEMedicare PIN
PA677829Medicare ID - Type Unspecified
NJ609427UWYMedicare PIN
NJ609427P7FMedicare PIN
NJ609427MK3Medicare PIN
NJ609427P7GMedicare PIN
NJ609427DPHMedicare PIN
PA814102OtherFIRST PRIORITY HEALTH
NJ609427CLDMedicare PIN
NJE08898Medicare UPIN