Provider Demographics
NPI:1609068451
Name:ALBERTO T DOODE MD
Entity Type:Organization
Organization Name:ALBERTO T DOODE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOODE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-776-8044
Mailing Address - Street 1:2116 SUNSET AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4652
Mailing Address - Country:US
Mailing Address - Phone:732-776-8044
Mailing Address - Fax:732-776-8074
Practice Address - Street 1:2116 SUNSET AVENUE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4652
Practice Address - Country:US
Practice Address - Phone:732-776-8044
Practice Address - Fax:732-776-8074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02830900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJY11008Medicare UPIN
079477Medicare PIN