Provider Demographics
NPI:1306089180
Name:NEW YORK ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:NEW YORK ENDOSCOPY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-683-1619
Mailing Address - Street 1:2 GANNETT DRIVE
Mailing Address - Street 2:STE 104
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-3404
Mailing Address - Country:US
Mailing Address - Phone:914-683-1619
Mailing Address - Fax:914-372-9900
Practice Address - Street 1:2 GANNETT DRIVE
Practice Address - Street 2:STE 104
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3404
Practice Address - Country:US
Practice Address - Phone:914-683-1619
Practice Address - Fax:914-372-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty