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Organization

M. CALHOUN THOMAS MD

Active
Other names
Park Avenue Pediatrics Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MONTRAE CALHOUN THOMAS MD (PHYSICIAN)
(973) 672-2770
Entity
Organization

Contact information

Practice address
485 PARK AVENUE, ORANGE, NJ 07050
(973) 672-2770
(973) 672-7009
Mailing address
485 PARK AVENUE, ORANGE, NJ 07050
(973) 672-2770
(973) 672-7009

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA035250
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3608409
NJ
Enumeration date
04/13/2007
Last updated
07/31/2008
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