Provider Demographics
NPI:1306570221
Name:NAVESINK INFECTIOUS DISEASES LLC
Entity type:Organization
Organization Name:NAVESINK INFECTIOUS DISEASES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:MAHMOOD
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-895-1770
Mailing Address - Street 1:200 PERRINE RD STE 223
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2836
Mailing Address - Country:US
Mailing Address - Phone:732-895-1770
Mailing Address - Fax:732-362-7773
Practice Address - Street 1:200 PERRINE RD STE 223
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2836
Practice Address - Country:US
Practice Address - Phone:732-895-1770
Practice Address - Fax:732-362-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty