Provider Demographics
NPI:1992960728
Name:MANHATTAN COLORECTAL SURGICAL UNIT
Entity type:Organization
Organization Name:MANHATTAN COLORECTAL SURGICAL UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:PENZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-675-2997
Mailing Address - Street 1:36 7TH AVE
Mailing Address - Street 2:SUITE 522
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6609
Mailing Address - Country:US
Mailing Address - Phone:212-675-2997
Mailing Address - Fax:212-627-8389
Practice Address - Street 1:36 7TH AVE
Practice Address - Street 2:SUITE 522
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6609
Practice Address - Country:US
Practice Address - Phone:212-675-2997
Practice Address - Fax:212-627-8389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy