Organization
CREST SPORTS TRNG PHYL THPY
Active
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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