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1730156217
THEODORE J SOUTHGATE
NEWARK, NJ
NPI
1730156217
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: NJ 25MA05005700)
Enumeration Date
2006-03-03
Last Update Date
2007-07-08
Business Address
-- THEODORE J SOUTHGATE MD
201 LYONS AVE SUITE G5
NEWARK, NJ 07112-2027
Phone number: 973-926-7749
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Mailing Address
-- THEODORE J SOUTHGATE MD
201 LYONS AVE SUITE G5
NEWARK, NJ 07112-2027
Phone number: 973-926-7749
Copy
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