| Infectious Disease Associates Pa | |
|
78 Omega Dr Bldg C Newark DE 19713-2064 | |
| (302) 368-2883 | |
| (302) 368-2892 |
| Full Name | Infectious Disease Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 78 Omega Dr Bldg C, Newark, Delaware |
| Authorized Official Name and Position | Alfred Bacon (PRACTICE OWNER) |
| Authorized Official Contact | 3023682883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Associates Pa 78 Omega Dr Bldg C Newark DE 19713-2064 Ph: (302) 368-2883 | Infectious Disease Associates Pa 78 Omega Dr Bldg C Newark DE 19713-2064 Ph: (302) 368-2883 |
| NPI Number | 1205904679 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 06/17/2021 |
| Medicare PECOS PAC ID | 1052337201 |
|---|---|
| Medicare Enrollment ID | O20051018000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205904679 | NPI | - | NPPES |
| 0000350102 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | David Meyer Cohen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1306907902 PECOS PAC ID: 5193717411 Enrollment ID: I20040330000656 |
| Provider Name | Stephanie A Lee |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912068529 PECOS PAC ID: 0749207066 Enrollment ID: I20051028000286 |
| Provider Name | Alfred E Bacon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902967508 PECOS PAC ID: 9638195886 Enrollment ID: I20080904000286 |
| Provider Name | William P Mazur |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518250828 PECOS PAC ID: 7810160587 Enrollment ID: I20111026000289 |
| Provider Name | John P Piper |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083775654 PECOS PAC ID: 1850478538 Enrollment ID: I20111213000291 |
| Provider Name | Kristen Leigh Facciolo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487914834 PECOS PAC ID: 9032341946 Enrollment ID: I20170821000930 |
| Provider Name | Angela J Oates |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447437868 PECOS PAC ID: 3375730583 Enrollment ID: I20220531001292 |
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