Provider Demographics
NPI:1285680694
Name:INFECTIOUS DISEASE PHYSICIANS, PA
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANTOLIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-866-7466
Mailing Address - Street 1:1001 BRIGGS RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4100
Mailing Address - Country:US
Mailing Address - Phone:856-866-7466
Mailing Address - Fax:856-866-9088
Practice Address - Street 1:1001 BRIGGS RD
Practice Address - Street 2:SUITE 250
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4100
Practice Address - Country:US
Practice Address - Phone:856-866-7466
Practice Address - Fax:856-866-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty