Provider Demographics
NPI:1093095499
Name:WINTHROP INFECTIOUS DISEASE ASSOCIATES UNIV FACULTY PRACTICE CORP
Entity Type:Organization
Organization Name:WINTHROP INFECTIOUS DISEASE ASSOCIATES UNIV FACULTY PRACTICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BURKE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CUNHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-663-2507
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 432
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3800
Mailing Address - Country:US
Mailing Address - Phone:516-663-2507
Mailing Address - Fax:516-663-3234
Practice Address - Street 1:222 STATION PLZ N
Practice Address - Street 2:SUITE 432
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3800
Practice Address - Country:US
Practice Address - Phone:516-663-2507
Practice Address - Fax:516-663-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty