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Individual

DR. THEODORE A. D'AMATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
214 CHAMBERSBRIDGE RD, BRICK, NJ 08723-2802
(732) 836-1374
(732) 936-1384
Mailing address
214 CHAMBERSBRIDGE RD, BRICK, NJ 08723-2802
(732) 836-1374
(732) 936-1384

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00271000
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
N005580
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8925607
NJ
Enumeration date
09/16/2006
Last updated
10/17/2011
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