Provider Demographics
NPI:1851489785
Name:DIGESTIVE DISEASE ASSOCIATES OF ROCKLAND PC
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE ASSOCIATES OF ROCKLAND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-354-3700
Mailing Address - Street 1:974 ROUTE 45
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:845-354-3700
Mailing Address - Fax:845-354-5439
Practice Address - Street 1:974 ROUTE 45
Practice Address - Street 2:SUITE 2000
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970
Practice Address - Country:US
Practice Address - Phone:845-354-3700
Practice Address - Fax:845-354-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W02481Medicare ID - Type Unspecified