MEDICARE: NEW JERSEY INFECTIOUS DISEASE ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134315302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW JERSEY INFECTIOUS DISEASE ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	113 JAMES ST
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-3946
Country	:	US
Telephone Number	:	732-906-1900
Fax Number	:	732-906-6666

Provider Business Practice Location Address
First Line	:	113 JAMES ST
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-3946
Country	:	US
Telephone Number	:	732-906-1900
Fax Number	:	732-906-6666

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	VASILIOS N. VELMAHOS
Credential	:	M.D.
Telephone Number	:	732-906-1900

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	09/20/2007

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