Advanced Infectious Disease Medical, LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

25MA09020700 Issued in NJ

Legal business name

ADVANCED INFECTIOUS DISEASE MEDICAL, LLC

Practice address

331 Grand St
Ground Floor
Hoboken, NJ 07030-2719

Phone

(201) 238-2888

NPI assigned

Oct 23, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Avisheh Forouzesh, M.D

Title

Physician

Phone

(201) 238-2888

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1730517053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WASHINGTON ST",
            "address_2": "PMB #603",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304883",
            "telephone_number": "201-238-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 GRAND ST",
            "address_2": "GROUND FLOOR",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302719",
            "telephone_number": "201-238-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INFECTIOUS DISEASE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "FOROUZESH",
        "authorized_official_first_name": "AVISHEH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "201-238-2888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA09020700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariane Ackerman
• Kerry Robyn Ackerman, MS
• Deborah Yvonne Adamo, L.C.S.W.
• Alisha Adhikari, MD
• Advanced Dental Group of Hoboken, P.C.
• Advanced Support Services LLC
• Sandra Marie Aguero, PHARMD
• Raul Francisco Aguilar, M.D.
• Nana Agyemang, RPH
• Imtiaz Ahmad, M.D.

• Infectious Disease Physician in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Infectious Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.