Provider Demographics
NPI:1538384425
Name:CENTRAL JERSEY INFECTIOUS DISEASES, PC
Entity type:Organization
Organization Name:CENTRAL JERSEY INFECTIOUS DISEASES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CJID, PC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:732-792-0741
Mailing Address - Street 1:215 GORDONS CORNER RD STE 2J
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3352
Mailing Address - Country:US
Mailing Address - Phone:732-792-0741
Mailing Address - Fax:732-792-0745
Practice Address - Street 1:215 GORDONS CORNER RD STE 2J
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3352
Practice Address - Country:US
Practice Address - Phone:732-792-0741
Practice Address - Fax:732-792-0745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04894600207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1265523021OtherNPI (INDIVIDUAL)
NJE53148Medicare UPIN