Provider Demographics
NPI:1427241892
Name:LONG ISLAND DIGESTIVE DISEASE CONSULTANTS, P.C.
Entity type:Organization
Organization Name:LONG ISLAND DIGESTIVE DISEASE CONSULTANTS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-751-8700
Mailing Address - Street 1:3400 NESCONSET HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3327
Mailing Address - Country:US
Mailing Address - Phone:631-751-8700
Mailing Address - Fax:631-751-5971
Practice Address - Street 1:3400 NESCONSET HWY STE 101
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3327
Practice Address - Country:US
Practice Address - Phone:631-751-8700
Practice Address - Fax:631-751-5971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LONG ISLAND DIGESTIVE DISEASE CONSULTANTS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical