Basic Information
| Provider Information | |||||||||
| NPI: | 1841381134 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGUEROA | ||||||||
| FirstName: | TEODORO | ||||||||
| MiddleName: | ERNESTO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 191 | ||||||||
| Address2: | PROVIDER ENROLLMENT | ||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197320191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026516212 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 ROCKLAND ROAD | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198033607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514000 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 10/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2088P0231X | 25MA0692900 | NJ | N | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology | 2088P0231X | C10004313 | DE | Y | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology | 208800000X | C10004313 | DE | N | Allopathic & Osteopathic Physicians | Urology | 2088P0231X | ME130543 | FL | N | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology |
ID Information
| ID | Type | State | Issuer | Description | 020348700 | 05 | FL | MEDICAID | 1589468 | 05 | NY | MEDICAID | 206278 | 05 | AL | MEDICAID | 2193612 | 05 | MD | MEDICAID | 1477497 | 05 | PA | MEDICAID | 7500271 | 05 | VA | MEDICAID | 6175406 | 05 | NJ | MEDICAID |