Individual
DR. THERESA MARIE IMPEDUGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
83 SUMMIT AVE, HACKENSACK, NJ 07601-1262
(201) 646-0010
(201) 646-0600
Mailing address
83 SUMMIT AVE, HACKENSACK, NJ 07601-1262
(201) 646-0010
(201) 646-0600
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
195134
NY
2086S0129X
Vascular Surgery Physician
Primary
MA72668
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03817627
—
NY
Enumeration date
06/07/2006
Last updated
09/28/2017
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