Provider Demographics
NPI:1891049441
Name:ISLAND DIGESTIVE HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:ISLAND DIGESTIVE HEALTH CENTER, 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
Mailing Address - Street 2:STE 300
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1068
Mailing Address - Country:US
Mailing Address - Phone:215-589-9024
Mailing Address - Fax:833-705-6301
Practice Address - Street 1:471 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4414
Practice Address - Country:US
Practice Address - Phone:631-376-2260
Practice Address - Fax:631-376-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical