Provider Demographics
NPI:1720215320
Name:EAST SIDE ENDOSCOPY LLC
Entity Type:Organization
Organization Name:EAST SIDE ENDOSCOPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOHLFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-589-9024
Mailing Address - Street 1:2500 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1098
Mailing Address - Country:US
Mailing Address - Phone:215-589-9024
Mailing Address - Fax:833-705-6301
Practice Address - Street 1:380 2ND AVE
Practice Address - Street 2:CONCOURSE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5615
Practice Address - Country:US
Practice Address - Phone:212-375-1065
Practice Address - Fax:212-375-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical