| Gastroenterology & Nutrition, Pc | |
|
10816 72nd Ave 2 Floor Forest Hills NY 11375-5653 | |
| (718) 261-0900 | |
| (718) 261-0944 |
| Full Name | Gastroenterology & Nutrition, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10816 72nd Ave, Forest Hills, New York |
| Authorized Official Name and Position | Samuel Davidoff (OFFICER) |
| Authorized Official Contact | 7182610900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology & Nutrition, Pc 10816 72nd Ave 2 Floor Forest Hills NY 11375-5653 Ph: (718) 261-0900 | Gastroenterology & Nutrition, Pc 10816 72nd Ave 2 Floor Forest Hills NY 11375-5653 Ph: (718) 261-0900 |
| NPI Number | 1427214949 |
|---|---|
| Provider Enumeration Date | 08/04/2008 |
| Last Update Date | 10/12/2012 |
| Medicare PECOS PAC ID | 2567530736 |
|---|---|
| Medicare Enrollment ID | O20081001000735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427214949 | NPI | - | NPPES |
| 1922055276 | Other | NY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 229243 (New York) | Primary |
| Provider Name | Samuel Davidoff |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922055276 PECOS PAC ID: 5395734917 Enrollment ID: I20040510000487 |
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