Provider Demographics
NPI:1801897145
Name:ASSOCIATES IN INFECTIOUS DISEASE AND TROPICAL MEDICINE INC
Entity type:Organization
Organization Name:ASSOCIATES IN INFECTIOUS DISEASE AND TROPICAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:IEZZI
Authorized Official - Suffix:
Authorized Official - Credentials:D
Authorized Official - Phone:724-527-1975
Mailing Address - Street 1:PO BOX 38721
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-8721
Mailing Address - Country:US
Mailing Address - Phone:724-527-1975
Mailing Address - Fax:724-527-6589
Practice Address - Street 1:5230 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1304
Practice Address - Country:US
Practice Address - Phone:412-661-1633
Practice Address - Fax:412-661-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MD017686E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA071505Medicare ID - Type Unspecified
C28765Medicare UPIN