Provider Demographics
NPI:1679620736
Name:SIRIKE T AASMAA DO PA
Entity Type:Organization
Organization Name:SIRIKE T AASMAA DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SIRIKE
Authorized Official - Middle Name:TRUUMEES
Authorized Official - Last Name:AASMAA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-575-5150
Mailing Address - Street 1:170 CHANGEBRIDGE RD
Mailing Address - Street 2:SUITE D1
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045
Mailing Address - Country:US
Mailing Address - Phone:973-575-5150
Mailing Address - Fax:973-575-5271
Practice Address - Street 1:170 CHANGEBRIDGE RD
Practice Address - Street 2:SUITE D1
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045
Practice Address - Country:US
Practice Address - Phone:973-575-5150
Practice Address - Fax:973-575-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
034388Medicare ID - Type Unspecified