=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043516461
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METRO INFECTIOUS DISEASES SPECIALISTS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2011
-----------------------------------------------------
Last Update Date | 07/24/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1445 ROUTE 130
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-609-5755
-----------------------------------------------------
Fax | 732-608-5221
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 WESTWINDS DR
-----------------------------------------------------
City | PRINCETON JUNCTION
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550-2306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-609-1739
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | M.D.
-----------------------------------------------------
Name | UDAY KUMAR
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 732-609-1739
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 25MA09557400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------