Provider Demographics
NPI:1326273780
Name:HUNTINGTON ENDOSCOPY OFFICE BASED SURGERY
Entity Type:Organization
Organization Name:HUNTINGTON ENDOSCOPY OFFICE BASED SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARMEL
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-421-2185
Mailing Address - Street 1:152 E MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2958
Mailing Address - Country:US
Mailing Address - Phone:631-421-2185
Mailing Address - Fax:631-421-3741
Practice Address - Street 1:152 E MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2958
Practice Address - Country:US
Practice Address - Phone:631-421-2185
Practice Address - Fax:631-421-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical