Provider Demographics
NPI:1609019819
Name:AE&LY AMBULATORY ENDOSCOPY PLLC
Entity Type:Organization
Organization Name:AE&LY AMBULATORY ENDOSCOPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-321-3262
Mailing Address - Street 1:13252 41ST AVE APT MC
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5847
Mailing Address - Country:US
Mailing Address - Phone:718-321-3262
Mailing Address - Fax:718-321-3263
Practice Address - Street 1:13252 41ST AVE APT MC
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5847
Practice Address - Country:US
Practice Address - Phone:718-321-3262
Practice Address - Fax:718-321-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty