| Westchester Digestive Disease Group, Llp | |
|
469 N Broadway Yonkers NY 10701-1923 | |
| (914) 969-1115 | |
| (914) 968-0402 |
| Full Name | Westchester Digestive Disease Group, Llp |
|---|---|
| Speciality | Internal Medicine |
| Location | 469 N Broadway, Yonkers, New York |
| Authorized Official Name and Position | Peter K Wayne (PARTNER) |
| Authorized Official Contact | 9149691115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westchester Digestive Disease Group, Llp 469 N Broadway Yonkers NY 10701-1923 Ph: (914) 969-1115 | Westchester Digestive Disease Group, Llp 469 N Broadway Yonkers NY 10701-1923 Ph: (914) 969-1115 |
| NPI Number | 1396920872 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 05/09/2008 |
| Medicare PECOS PAC ID | 4981610490 |
|---|---|
| Medicare Enrollment ID | O20060221000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396920872 | NPI | - | NPPES |
| CC7825 | Other | NY | PALMETTO GBA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 132616 (New York) | Primary |
| Provider Name | Peter Wayne |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831193457 PECOS PAC ID: 7214975416 Enrollment ID: I20050419000773 |
| Provider Name | Orest J Kozicky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861496481 PECOS PAC ID: 1254346992 Enrollment ID: I20060216000118 |
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