Provider Demographics
NPI:1457679110
Name:HILLSBOROUGH INFECTIOUS DISEASES MEDICINE PRACTICE
Entity Type:Organization
Organization Name:HILLSBOROUGH INFECTIOUS DISEASES MEDICINE PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARATI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-979-0035
Mailing Address - Street 1:2 TODD ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-7127
Mailing Address - Country:US
Mailing Address - Phone:732-979-0035
Mailing Address - Fax:
Practice Address - Street 1:403 TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4698
Practice Address - Country:US
Practice Address - Phone:732-979-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07206700207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty