Provider Demographics
NPI:1225083124
Name:BEKE, THEODORE JAMES (MD)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:JAMES
Last Name:BEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:367 HILLVIEW TER
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1013
Mailing Address - Country:US
Mailing Address - Phone:201-337-1888
Mailing Address - Fax:201-337-1889
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1439
Practice Address - Country:US
Practice Address - Phone:201-647-9403
Practice Address - Fax:201-847-0059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA039090207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology