Provider Demographics
NPI:1154543486
Name:TWIN RIVERS GASTROENTEROLOGY CENTER,INC
Entity type:Organization
Organization Name:TWIN RIVERS GASTROENTEROLOGY CENTER,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDROW
Authorized Official - Suffix:
Authorized Official - Credentials:CMM
Authorized Official - Phone:610-258-6635
Mailing Address - Street 1:20 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2658
Mailing Address - Country:US
Mailing Address - Phone:610-258-6635
Mailing Address - Fax:610-258-2879
Practice Address - Street 1:20 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2658
Practice Address - Country:US
Practice Address - Phone:610-258-6635
Practice Address - Fax:610-258-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical MicrobiologyGroup - Single Specialty