Provider Demographics
NPI:1861658908
Name:SHEEPSHEAD BAY ENDOSCOPY AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SHEEPSHEAD BAY ENDOSCOPY AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MITCHEL
Authorized Official - Last Name:TENNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-368-2960
Mailing Address - Street 1:2211 EMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2792
Mailing Address - Country:US
Mailing Address - Phone:718-368-2960
Mailing Address - Fax:718-368-2249
Practice Address - Street 1:2211 EMMONS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2792
Practice Address - Country:US
Practice Address - Phone:718-368-2960
Practice Address - Fax:718-368-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty