Organization
CREST SPORTS TRNG PHYL THPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH JOHN CALABRO DO (PRESIDENT)
(732) 212-0060
Entity
Organization
Contact information
Practice address
1904 ATLANTIC AVE, MANASQUAN, NJ 08736-1006
(732) 212-0060
Mailing address
66 W GILBERT ST, SUITE 100, RED BANK, NJ 07701-4918
(732) 212-0060
(732) 212-0061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NJ
2251X0800X
Orthopedic Physical Therapist
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE8996
RAILROAD MEDICARE
NJ
Enumeration date
05/19/2006
Last updated
07/21/2022
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