Provider Demographics
NPI:1740325398
Name:DR. ANTHONY CALZARETTO
Entity type:Organization
Organization Name:DR. ANTHONY CALZARETTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:CALZARETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-667-0505
Mailing Address - Street 1:401 COOPER LANDING RD STE C17
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2587
Mailing Address - Country:US
Mailing Address - Phone:856-667-0505
Mailing Address - Fax:856-667-8083
Practice Address - Street 1:401 COOPER LANDING RD STE C17
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2587
Practice Address - Country:US
Practice Address - Phone:856-667-0505
Practice Address - Fax:856-667-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ738540Medicare ID - Type Unspecified