Provider Demographics
NPI:1568098523
Name:PROCEDURE ENDOSCOPY SERVICES PLLC
Entity Type:Organization
Organization Name:PROCEDURE ENDOSCOPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRANPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:PARMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-528-4384
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-0413
Mailing Address - Country:US
Mailing Address - Phone:718-605-5000
Mailing Address - Fax:718-605-5004
Practice Address - Street 1:305 SEGUINE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3709
Practice Address - Country:US
Practice Address - Phone:718-605-5000
Practice Address - Fax:718-605-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02350521Medicaid