Provider Demographics
NPI:1932251238
Name:CRANFORD OPHTHALMOLOGY, P.A.
Entity Type:Organization
Organization Name:CRANFORD OPHTHALMOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:CALDERONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACS
Authorized Official - Phone:908-276-3030
Mailing Address - Street 1:2 SOUTH AVE E
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2811
Mailing Address - Country:US
Mailing Address - Phone:908-276-3030
Mailing Address - Fax:908-276-3174
Practice Address - Street 1:2 SOUTH AVE E
Practice Address - Street 2:SUITE 1
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2811
Practice Address - Country:US
Practice Address - Phone:908-276-3030
Practice Address - Fax:908-276-3174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04312900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0867070001Medicare NSC