Provider Demographics
NPI:1194178079
Name:DIGESTIVE DISEASE MEDICINE OF OSWEGO COUNTY,PLLC
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE MEDICINE OF OSWEGO COUNTY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BISHNU
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPKOTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-312-0089
Mailing Address - Street 1:105 COUNTY ROUTE 45A
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-6664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 COUNTY ROUTE 45A
Practice Address - Street 2:SUITE 400
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6664
Practice Address - Country:US
Practice Address - Phone:315-312-0089
Practice Address - Fax:315-312-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260829174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty