Provider Demographics
NPI:1841562758
Name:AAA GASTROINTESTINAL PC
Entity Type:Organization
Organization Name:AAA GASTROINTESTINAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-795-1021
Mailing Address - Street 1:499 FORT WASHINGTON AVE
Mailing Address - Street 2:SUITE PE1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4609
Mailing Address - Country:US
Mailing Address - Phone:212-795-1021
Mailing Address - Fax:212-795-1002
Practice Address - Street 1:499 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE PE1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033
Practice Address - Country:US
Practice Address - Phone:646-599-0728
Practice Address - Fax:646-576-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170703207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty