Basic Information
| Provider Information | |||||||||
| NPI: | 1316155898 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AIA NETWORK, LLC | ||||||||
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| OtherOrganizationName: | ABILITIES IN ACTION, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 BRIDGEWATERS DRIVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | OCEANPORT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325426600 | ||||||||
| FaxNumber: | 7325426606 | ||||||||
| Practice Location | |||||||||
| Address1: | 14 BRIDGEWATERS DRIVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | OCEANPORT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325426600 | ||||||||
| FaxNumber: | 7325426606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CALDARELLA | ||||||||
| AuthorizedOfficialFirstName: | ANOTHONY | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7325426600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | 40QA00709100 | NJ | X | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | 225XP0200X | NJ | X | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | 235Z00000X | NJ | X | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.