Provider Demographics
NPI:1902420680
Name:INFOSTRUCTURES, INC.
Entity Type:Organization
Organization Name:INFOSTRUCTURES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSERTZUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-417-7171
Mailing Address - Street 1:1390 PICCARD DR STE 330
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6540
Mailing Address - Country:US
Mailing Address - Phone:301-417-7171
Mailing Address - Fax:
Practice Address - Street 1:1390 PICCARD DR STE 330
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6540
Practice Address - Country:US
Practice Address - Phone:301-417-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management