Provider Demographics
NPI:1477075299
Name:COLORECTAL SURGERY SERVICES PLLC
Entity Type:Organization
Organization Name:COLORECTAL SURGERY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CALIENDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-248-2422
Mailing Address - Street 1:2200 NORTHERN BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1220
Mailing Address - Country:US
Mailing Address - Phone:516-248-2422
Mailing Address - Fax:516-248-5162
Practice Address - Street 1:2200 NORTHERN BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548
Practice Address - Country:US
Practice Address - Phone:516-248-2422
Practice Address - Fax:516-248-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty