| Islandwide Gastroenterology Pc | |
|
901 Stewart Ave Suite 240 Garden City NY 11530-4893 | |
| (516) 458-6258 | |
| (631) 223-2271 |
| Full Name | Islandwide Gastroenterology Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 901 Stewart Ave, Garden City, New York |
| Authorized Official Name and Position | Philip Raymond Cassar (CEO) |
| Authorized Official Contact | 5164586258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Islandwide Gastroenterology Pc 14 Maurice Ln Huntington NY 11743-1843 Ph: (516) 458-6258 | Islandwide Gastroenterology Pc 901 Stewart Ave Suite 240 Garden City NY 11530-4893 Ph: (516) 458-6258 |
| NPI Number | 1427290907 |
|---|---|
| Provider Enumeration Date | 03/31/2009 |
| Last Update Date | 03/24/2011 |
| Medicare PECOS PAC ID | 2961555602 |
|---|---|
| Medicare Enrollment ID | O20090729000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427290907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 233299 (New York) | Primary |
| Provider Name | Robert J Bonasera |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073537767 PECOS PAC ID: 4082613385 Enrollment ID: I20061214000433 |
| Provider Name | Kenneth Levine |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083677454 PECOS PAC ID: 3274635453 Enrollment ID: I20070219000156 |
| Provider Name | Daniel J Ulicny |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043273402 PECOS PAC ID: 1658465109 Enrollment ID: I20070914000564 |
| Provider Name | Philip R Cassar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891868857 PECOS PAC ID: 8325111925 Enrollment ID: I20080715000547 |
| Provider Name | Julio K Kim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831357698 PECOS PAC ID: 0547336992 Enrollment ID: I20080909000052 |
| Provider Name | Seema Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730314535 PECOS PAC ID: 8426101668 Enrollment ID: I20090805000275 |
| Provider Name | Zhanqing Yan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1215929781 PECOS PAC ID: 6002097417 Enrollment ID: I20110217000774 |
| Provider Name | Aditya Marwaha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811122716 PECOS PAC ID: 8628252954 Enrollment ID: I20110412000520 |
| Provider Name | Eleazer Yousefzadeh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700029485 PECOS PAC ID: 9830348028 Enrollment ID: I20140809000104 |
| Provider Name | Qinghu Ren |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376773978 PECOS PAC ID: 3779895172 Enrollment ID: I20160920001810 |
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