Provider Demographics
NPI:1003830548
Name:INFECTIOUS DISEASES CONSULTANTS OF NEW JERSEY PA
Entity Type:Organization
Organization Name:INFECTIOUS DISEASES CONSULTANTS OF NEW JERSEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-795-7505
Mailing Address - Street 1:103 E GATE DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2803
Mailing Address - Country:US
Mailing Address - Phone:856-795-7505
Mailing Address - Fax:856-795-8010
Practice Address - Street 1:103 E GATE DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2803
Practice Address - Country:US
Practice Address - Phone:856-795-7505
Practice Address - Fax:856-795-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty