Provider Demographics
NPI:1821040734
Name:STORCH, IAN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:MICHAEL
Last Name:STORCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 MARCUS AVENUE
Mailing Address - Street 2:SUITE 240E
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-673-4801
Mailing Address - Fax:516-673-4804
Practice Address - Street 1:2001 MARCUS AVE
Practice Address - Street 2:SUITE 240E
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-673-4801
Practice Address - Fax:516-673-4804
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY224279207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology