Provider Demographics
NPI:1184626509
Name:CALISE, ARTHUR G (DO)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:G
Last Name:CALISE
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:721-212-0060
Mailing Address - Fax:732-212-0061
Practice Address - Street 1:1 BAY AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4837
Practice Address - Country:US
Practice Address - Phone:973-877-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06007700208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ20349OtherUHP-NON PAR
NJ6863302Medicaid
NJ6863302Medicaid
NJ851594DLEMedicare PIN
NJ851594DPKMedicare PIN
NJ851594UXKMedicare PIN
NJ851594CLDMedicare PIN
NJ851594NSEMedicare PIN
NJ851594DPHMedicare PIN
NJ20349OtherUHP-NON PAR
NJ851594P7GMedicare PIN
NJ851594UWYMedicare PIN
NJ851594UXLMedicare PIN
NJ851594MK3Medicare PIN