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Contact Information

THEODORE ENDE, DO
422 WEST LACEY ROAD
FORKED RIVER, NJ08731-2518
 Phone: 609-693-1992
 Fax: 609-971-3199
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for THEODORE ENDE · (Male)

NPI Number 1093722480
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/01/2006
Last updated 07/18/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MB03165000
  • NJ Medicaid 0659703
Hospital affiliation(s)
  • COMMUNITY MEDICAL CENTER - (Acute Care)
    99 RT 37 WEST
    TOMS RIVER, NJ 08755
  • JERSEY SHORE UNIVERSITY MEDICAL CENTER - (Acute Care)
    1945 RTE 33
    NEPTUNE, NJ 07754
  • SOUTHERN OCEAN MEDICAL CENTER - (Acute Care)
    1140 RT 72 W
    MANAHAWKIN, NJ 08050
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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