Provider Demographics
NPI:1427683580
Name:GREATER HAZLETON GASTROENTEROLOGY, P.C.
Entity type:Organization
Organization Name:GREATER HAZLETON GASTROENTEROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-454-1400
Mailing Address - Street 1:10 PARK PL
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-2885
Mailing Address - Country:US
Mailing Address - Phone:570-617-6224
Mailing Address - Fax:570-454-2144
Practice Address - Street 1:10 PARK PL
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-2885
Practice Address - Country:US
Practice Address - Phone:570-617-6224
Practice Address - Fax:570-454-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty