Active NPI
Juan Luis Calderon, STL, LMT
- Religious Nonmedical Practitioner
- West New York, NJ
National Provider Identifier
1245724145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Practitioner
- License
- 18KT01274200
- Practice address
- 6002 Washington St
West New York, NJ 07093-1420 - Phone
- (201) 401-4204
- NPI assigned
- Jun 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Religious Nonmedical Practitioner | 374K00000X | 18KT01274200 | NJ | Primary |
Addresses
Primary practice location
6002 Washington St
West New York, NJ 07093-1420
Mailing address
PO Box 443
West New York, NJ 07093-0443
Phone (201) 401-4204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18KT01274200 | NJ | MD | Religious Nonmedical Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528934400000",
"number": "1245724145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 443",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070930443",
"telephone_number": "201-401-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6002 WASHINGTON ST",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070931420",
"telephone_number": "201-401-4204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "JUAN",
"middle_name": "LUIS",
"name_prefix": "Mr.",
"credential": "STL, LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2018-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": "NJ",
"license": "18KT01274200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West New York, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.