MEDICARE: INFECTIONS LIMITED EAST, PC

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	2080P0214X	Pediatric Pulmonology Physician
2	207RI0200X	Infectious Disease Physician

General Provider Information

NPI Number	:	1225093339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFECTIONS LIMITED EAST, PC

Provider Business Mailing Address
First Line	:	2106 NEW RD STE F1
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1053
Country	:	US
Telephone Number	:	609-926-5451
Fax Number	:	609-926-1372

Provider Business Practice Location Address
First Line	:	2106 NEW RD STE F1
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1053
Country	:	US
Telephone Number	:	609-926-5451
Fax Number	:	609-926-1372

Authorized Official
Title or Position	:	OWNER; DO; AUTHORIZED OFFICIAL
Name	:	ATHANASIOS G. PAPASTAMELOS
Credential	:
Telephone Number	:	609-926-5451

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	12/08/2021

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