Provider Demographics
NPI:1225093339
Name:INFECTIONS LIMITED EAST, PC
Entity Type:Organization
Organization Name:INFECTIONS LIMITED EAST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER; DO; AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ATHANASIOS
Authorized Official - Middle Name:G
Authorized Official - Last Name:PAPASTAMELOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-926-5451
Mailing Address - Street 1:2106 NEW RD STE F1
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1053
Mailing Address - Country:US
Mailing Address - Phone:609-926-5451
Mailing Address - Fax:609-926-1372
Practice Address - Street 1:2106 NEW RD STE F1
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1053
Practice Address - Country:US
Practice Address - Phone:609-926-5451
Practice Address - Fax:609-926-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8561303Medicaid
NJ8561303Medicaid