Provider Demographics
NPI:1316094824
Name:CAPE AND ISLANDS ENDOSCOPY CENTER LLC
Entity type:Organization
Organization Name:CAPE AND ISLANDS ENDOSCOPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRE
Authorized Official - Middle Name:K
Authorized Official - Last Name:NADER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-775-7751
Mailing Address - Street 1:700 ATTUCKS LN
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1809
Mailing Address - Country:US
Mailing Address - Phone:508-775-7751
Mailing Address - Fax:508-775-7752
Practice Address - Street 1:700 ATTUCKS LN
Practice Address - Street 2:UNIT 1B
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1809
Practice Address - Country:US
Practice Address - Phone:508-775-7751
Practice Address - Fax:508-775-7752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110070395BMedicaid