Provider Demographics
NPI:1558524298
Name:SAINT FRANCIS GI ENDOSCOPY L.L.C
Entity Type:Organization
Organization Name:SAINT FRANCIS GI ENDOSCOPY L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KELTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-683-9991
Mailing Address - Street 1:360 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2700
Mailing Address - Country:US
Mailing Address - Phone:561-330-3381
Mailing Address - Fax:561-330-3382
Practice Address - Street 1:360 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2700
Practice Address - Country:US
Practice Address - Phone:561-330-3381
Practice Address - Fax:561-330-3382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD300000044Medicare PIN
CTD300000044Medicare UPIN