Healthcare Provider Details

I. General information

NPI: 1588605232
Provider Name (Legal Business Name): UDELE JOYCE TAGOE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 BERGEN ST
NEWARK NJ
07103-2425
US

IV. Provider business mailing address

185 S ORANGE AVE
NEWARK NJ
07103-2757
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-2074
  • Fax: 973-972-2739
Mailing address:
  • Phone: 973-972-5266
  • Fax: 973-972-4574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number25MA09072800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: