Provider Demographics
NPI:1003251240
Name:P & I GASTROENTEROLOGY PC
Entity Type:Organization
Organization Name:P & I GASTROENTEROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAE GEUN
Authorized Official - Middle Name:
Authorized Official - Last Name:HYUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-321-3210
Mailing Address - Street 1:400 SYLVAN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2729
Mailing Address - Country:US
Mailing Address - Phone:718-321-3210
Mailing Address - Fax:718-321-1004
Practice Address - Street 1:400 SYLVAN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2729
Practice Address - Country:US
Practice Address - Phone:718-321-3210
Practice Address - Fax:718-321-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty