Provider Demographics
NPI:1669705778
Name:PENNINGTON INFECTIOUS DISEASE ASSOCIATES INC
Entity type:Organization
Organization Name:PENNINGTON INFECTIOUS DISEASE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAJASHREE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANANDAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-838-0688
Mailing Address - Street 1:PO BOX 48
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823
Mailing Address - Country:US
Mailing Address - Phone:609-838-0688
Mailing Address - Fax:609-838-0689
Practice Address - Street 1:2087 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-838-0688
Practice Address - Fax:609-838-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty