Provider Demographics
NPI:1992977672
Name:STONELEIGH MEDICAL ENDOSCOPY OBS PC
Entity type:Organization
Organization Name:STONELEIGH MEDICAL ENDOSCOPY OBS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-734-8224
Mailing Address - Street 1:1985 CROMPOND RD STE UPPER E
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-2400
Mailing Address - Country:US
Mailing Address - Phone:845-228-5385
Mailing Address - Fax:
Practice Address - Street 1:1071 STONELEIGH AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2400
Practice Address - Country:US
Practice Address - Phone:845-228-5385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical