Provider Demographics
NPI:1619285863
Name:ASSOCIATES IN INFECTIOUS DISEASE, PC
Entity Type:Organization
Organization Name:ASSOCIATES IN INFECTIOUS DISEASE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-748-4583
Mailing Address - Street 1:199 BROAD ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2635
Mailing Address - Country:US
Mailing Address - Phone:973-748-4583
Mailing Address - Fax:973-748-3243
Practice Address - Street 1:199 BROAD ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2635
Practice Address - Country:US
Practice Address - Phone:973-748-4583
Practice Address - Fax:973-748-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty