Provider Demographics
NPI:1396753166
Name:CENTER FOR INFECTIOUS DISEASES, P.A.
Entity type:Organization
Organization Name:CENTER FOR INFECTIOUS DISEASES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SEBTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-487-4088
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 507
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-487-4088
Mailing Address - Fax:201-489-8930
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 507
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-487-4088
Practice Address - Fax:201-489-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09331500207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ900899Medicare ID - Type Unspecified