Provider Demographics
NPI:1669414017
Name:MERCER INFECTIOUS DISEASE ASSOC
Entity type:Organization
Organization Name:MERCER INFECTIOUS DISEASE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NIGAHUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KARABULUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-394-6245
Mailing Address - Street 1:40 FULD ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-5247
Mailing Address - Country:US
Mailing Address - Phone:609-394-6245
Mailing Address - Fax:302-239-2105
Practice Address - Street 1:40 FULD ST
Practice Address - Street 2:SUITE 203
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-5247
Practice Address - Country:US
Practice Address - Phone:609-394-6245
Practice Address - Fax:302-239-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-06-23
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
NJ1533019OtherUNITED MINE WORKERS ASSOC
NJ01000350900OtherAMERICHOICE
NJ0727771000OtherAMERIHEALTH
NJ223312456OtherTAX ID
NJ6269303Medicaid
NJC11654OtherRAIL ROAD MEDICARE
NJ6269303Medicaid
NJ223312456OtherTAX ID