Provider Demographics
NPI:1629566757
Name:LI GASTROENTEROLOGY ENDOSCOPY PC
Entity Type:Organization
Organization Name:LI GASTROENTEROLOGY ENDOSCOPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUSHIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-636-5010
Mailing Address - Street 1:10 CHAUNCEY PL
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1233
Mailing Address - Country:US
Mailing Address - Phone:516-417-3854
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTHERN BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-636-5010
Practice Address - Fax:516-636-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty