Disandro, Theresa Maria
Disandro, Theresa Maria is an individual health care provider with primary practice located at 601 Route 73 N Ste 101 , Marlton NJ 08053-3472. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Disandro, Theresa Maria can be contacted via phone (856) 237-8045.Contact Information
Primary practice address
601 Route 73 N Ste 101
Marlton NJ 08053-3472
Phone: (856) 237-8045
Fax: (856) 237-8047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 25MB08554700 | New Jersey |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | OT010580 | Pennsylvania |
Profile Details
| NPI number | 1750544391 |
|---|---|
| LBN Legal business name | Disandro, Theresa Maria |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2008 |
| Last updated | Oct 22nd, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750544391 | NPPES |
| New Jersey | MEDICAID | 0198561 | |
| New Jersey | MEDICAID | 102316770 |
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