# INFECTIOUS DISEASE CONSULTANTS OF SOUTH JERSEY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639448806
- **Authorized official:** LYNN CARPENTER RN (OFFICE MANAGER)
- **Authorized official phone:** (609) 677-1046

## Contact information

- **Practice address:** 200 TRENTON RD, BROWNS MILLS, NJ 08015-1705
- **Practice address phone:** (609) 677-1046
- **Practice address fax:** (609) 677-1306
- **Mailing address:** PO BOX 1283, MEDFORD, NJ 08055-6283
- **Mailing address phone:** (609) 677-1046
- **Mailing address fax:** (609) 677-1306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 25MA02594500 | NJ | Yes |

## Other

- **Enumeration date:** 12/18/2011
- **Last updated:** 12/18/2011