Provider Demographics
NPI:1376647917
Name:UNIVERSITY HILL GASTROENTEROLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:UNIVERSITY HILL GASTROENTEROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE HEAD
Authorized Official - Prefix:DR
Authorized Official - First Name:AJOY
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-234-8977
Mailing Address - Street 1:5100 W TAFT RD
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3807
Mailing Address - Country:US
Mailing Address - Phone:315-234-8977
Mailing Address - Fax:315-234-8981
Practice Address - Street 1:5100 W TAFT RD
Practice Address - Street 2:SUITE 2G
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3807
Practice Address - Country:US
Practice Address - Phone:315-234-8977
Practice Address - Fax:315-234-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142063207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1394Medicare ID - Type Unspecified