Provider Demographics
NPI:1285886945
Name:MARSHALL GASTROINTESTINAL ENDOSCOPY, PC
Entity type:Organization
Organization Name:MARSHALL GASTROINTESTINAL ENDOSCOPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-593-4200
Mailing Address - Street 1:1800 ROCKAWAY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1665
Mailing Address - Country:US
Mailing Address - Phone:516-593-4200
Mailing Address - Fax:516-887-9120
Practice Address - Street 1:1800 ROCKAWAY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1665
Practice Address - Country:US
Practice Address - Phone:516-593-4200
Practice Address - Fax:516-887-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193405207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG45749Medicare UPIN
NY21N641Medicare PIN