Provider Demographics
NPI:1053366724
Name:CONTE, THEODORE JOSEPH (MD,)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:JOSEPH
Last Name:CONTE
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MADISON AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2721
Mailing Address - Country:US
Mailing Address - Phone:201-291-8489
Mailing Address - Fax:201-291-8487
Practice Address - Street 1:22 MADISON AVE STE 206
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2721
Practice Address - Country:US
Practice Address - Phone:201-291-8489
Practice Address - Fax:201-291-8487
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2084N0402X2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2425094OtherUNITED HEALTH CARE
NJ800029381OtherTRICARE
NJP0014735OtherRAIL ROAD MEDICARE
NJ2K7799OtherHEALTHNET
NJ611011600OtherDEPARTMENT OF LABOR
NJP3004984OtherOXFORD PROVIDER #
NJP0014735OtherRAIL ROAD MEDICARE
NJ2425094OtherUNITED HEALTH CARE
NJ075348SASMedicare ID - Type UnspecifiedPROVIDER NUMBER