Provider Demographics
NPI:1184943060
Name:CRRT, LLC
Entity type:Organization
Organization Name:CRRT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:G
Authorized Official - Last Name:CALDERONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-599-2778
Mailing Address - Street 1:512 UNION ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-2800
Mailing Address - Country:US
Mailing Address - Phone:609-599-2778
Mailing Address - Fax:609-599-2774
Practice Address - Street 1:512 UNION ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-2800
Practice Address - Country:US
Practice Address - Phone:609-599-2778
Practice Address - Fax:609-599-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1184943060OtherNPI
NJ0275743Medicaid
NJ1184943060OtherNPI