Provider Demographics
NPI:1316031503
Name:DIGESTIVE DISEASE ASSOCIATES, PC
Entity type:Organization
Organization Name:DIGESTIVE DISEASE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRETAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMPERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-980-9898
Mailing Address - Street 1:301 BUEL AVE
Mailing Address - Street 2:SIDE ENTRANCE
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2201
Mailing Address - Country:US
Mailing Address - Phone:718-980-9898
Mailing Address - Fax:718-980-9897
Practice Address - Street 1:1487 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2311
Practice Address - Country:US
Practice Address - Phone:718-980-9898
Practice Address - Fax:718-980-9897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210256207RG0100X
NY222044207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty