Provider Demographics
NPI:1467008839
Name:SZABELA INFECTIOUS DISEASE CONSULTING
Entity type:Organization
Organization Name:SZABELA INFECTIOUS DISEASE CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SZABELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-597-0704
Mailing Address - Street 1:P.O. BOX 579
Mailing Address - Street 2:
Mailing Address - City:FAR HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07931-0579
Mailing Address - Country:US
Mailing Address - Phone:239-597-0704
Mailing Address - Fax:239-597-0709
Practice Address - Street 1:111 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1909
Practice Address - Country:US
Practice Address - Phone:239-597-0704
Practice Address - Fax:239-597-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0581291Medicaid