| 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 |
| Certification 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 | () | 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 | David J Bergamo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851640452 PECOS PAC ID: 3173839362 Enrollment ID: I20150902002661 |
| Provider Name | Jacinta Gracias Hollinger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457702177 PECOS PAC ID: 3173818705 Enrollment ID: I20160822002536 |
| Provider Name | Kristen Leigh Facciolo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487914834 PECOS PAC ID: 9032341946 Enrollment ID: I20170821000930 |
| Provider Name | Kathryn Provonche |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790236644 PECOS PAC ID: 5496005167 Enrollment ID: I20180830002693 |
| Provider Name | Tara M Frye |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417575549 PECOS PAC ID: 7810311636 Enrollment ID: I20200727000017 |
| Provider Name | Alyssa Floyd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710596895 PECOS PAC ID: 0749605186 Enrollment ID: I20200803001463 |
| Provider Name | Clare F Holmes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558966614 PECOS PAC ID: 6204245368 Enrollment ID: I20210503001263 |
| Provider Name | Michelle K Bell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508112608 PECOS PAC ID: 5890190714 Enrollment ID: I20210816002202 |
| Provider Name | Angela J Oates |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447437868 PECOS PAC ID: 3375730583 Enrollment ID: I20220531001292 |
| Provider Name | Harry Rockower |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508429762 PECOS PAC ID: 9638566672 Enrollment ID: I20240510000168 |
| Provider Name | Pamela Bailey |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730509829 PECOS PAC ID: 5890913453 Enrollment ID: I20250827001443 |
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