Provider Demographics
NPI:1629175062
Name:SARATOGA SCHENECTADY ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:SARATOGA SCHENECTADY ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-831-1550
Mailing Address - Street 1:1 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-9618
Mailing Address - Country:US
Mailing Address - Phone:518-831-1525
Mailing Address - Fax:518-831-1551
Practice Address - Street 1:1 WELLNESS DR
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9618
Practice Address - Country:US
Practice Address - Phone:518-831-1550
Practice Address - Fax:518-831-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4550200R261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPP00177783Medicare PIN