Provider Demographics
NPI:1710196738
Name:GREATER NEW YORK GASTROENTEROLOGY, PC
Entity Type:Organization
Organization Name:GREATER NEW YORK GASTROENTEROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HON-MING
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-253-2118
Mailing Address - Street 1:137 5TH AVE
Mailing Address - Street 2:7TH FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7103
Mailing Address - Country:US
Mailing Address - Phone:212-253-2118
Mailing Address - Fax:
Practice Address - Street 1:137 5TH AVE
Practice Address - Street 2:7TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7103
Practice Address - Country:US
Practice Address - Phone:212-253-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198126-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02137800Medicaid
G96952Medicare UPIN
NY02137800Medicaid