Active NPI
Philip Louis Infantolino, M.D.
- Specialist
- Manasquan, NJ
National Provider Identifier
1790759983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA23189
- Practice address
- 2640 Highway 70
Building 11
Manasquan, NJ 08736-2609 - Phone
- (732) 528-8500
- Fax
- (732) 528-6710
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA23189 | NJ | Primary |
Addresses
Primary practice location
2640 Highway 70
Building 11
Manasquan, NJ 08736-2609
Mailing address
2640 Highway 70
Building 11
Manasquan, NJ 08736-2609
Phone (732) 528-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA23189 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trabecular Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rheumatology Physician
- Voorhees, NJ
- NPI 1427622661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205452800000",
"number": "1790759983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 HIGHWAY 70",
"address_2": "BUILDING 11",
"city": "MANASQUAN",
"state": "NJ",
"postal_code": "087362609",
"telephone_number": "732-528-8500",
"fax_number": "732-528-6710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2640 HIGHWAY 70",
"address_2": "BUILDING 11",
"city": "MANASQUAN",
"state": "NJ",
"postal_code": "087362609",
"telephone_number": "732-528-8500",
"fax_number": "732-528-6710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INFANTOLINO",
"first_name": "PHILIP",
"middle_name": "LOUIS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2008-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "MA23189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manasquan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.