Provider Demographics
NPI:1881047405
Name:MIDDLESEX INFECTIOUS DISEASES LLC
Entity type:Organization
Organization Name:MIDDLESEX INFECTIOUS DISEASES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANKUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-249-9512
Mailing Address - Street 1:3 MELBLOUM LN
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2780
Mailing Address - Country:US
Mailing Address - Phone:732-910-6961
Mailing Address - Fax:908-325-1940
Practice Address - Street 1:3 MELBLOUM LN
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2780
Practice Address - Country:US
Practice Address - Phone:732-910-6961
Practice Address - Fax:908-325-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty