Provider Demographics
NPI:1083896062
Name:GASTROENTEROLOGY OF WESTCHESTER OBS LLC PLLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY OF WESTCHESTER OBS LLC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-375-6400
Mailing Address - Street 1:970 NORTH BROADWAY
Mailing Address - Street 2:SUITE 305B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701
Mailing Address - Country:US
Mailing Address - Phone:914-375-6400
Mailing Address - Fax:914-375-2831
Practice Address - Street 1:970 NORTH BROADWAY
Practice Address - Street 2:SUITE 305B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-375-6400
Practice Address - Fax:914-375-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty