Provider Demographics
NPI:1942367198
Name:VEGA, TERESA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:L
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PARSONAGE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2475
Mailing Address - Country:US
Mailing Address - Phone:732-494-6226
Mailing Address - Fax:732-494-8762
Practice Address - Street 1:10 PARSONAGE RD STE 500
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2475
Practice Address - Country:US
Practice Address - Phone:732-494-6226
Practice Address - Fax:732-494-8762
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03806300207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ595474BBFMedicare ID - Type Unspecified
NJD97095Medicare UPIN