Provider Demographics
NPI:1578824884
Name:NORTHAMPTON INFECTIOUS DISEASE PHYSICIAN ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTHAMPTON INFECTIOUS DISEASE PHYSICIAN ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-657-1659
Mailing Address - Street 1:4201 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-6936
Mailing Address - Country:US
Mailing Address - Phone:610-657-1659
Mailing Address - Fax:610-924-7311
Practice Address - Street 1:4201 WILSON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-6936
Practice Address - Country:US
Practice Address - Phone:610-657-1659
Practice Address - Fax:610-924-7311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA423705207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH31900Medicare UPIN