Provider Demographics
NPI:1952710808
Name:CRRT, LLC
Entity Type:Organization
Organization Name:CRRT, LLC
Other - Org Name:CRRT AT MERWICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:CALDERONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-528-7102
Mailing Address - Street 1:100 PLAINSBORO RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1914
Mailing Address - Country:US
Mailing Address - Phone:609-275-5550
Mailing Address - Fax:609-599-2774
Practice Address - Street 1:100 PLAINSBORO RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1914
Practice Address - Country:US
Practice Address - Phone:609-275-5550
Practice Address - Fax:609-599-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24952261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0275743Medicaid
NJ312605Medicare PIN