Provider Demographics
NPI:1932321882
Name:DIGESTIVE HEALTH CENTER OF HUNTINGTON
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH CENTER OF HUNTINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-385-8677
Mailing Address - Street 1:195 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-385-8677
Mailing Address - Fax:631-385-0611
Practice Address - Street 1:195 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-385-8677
Practice Address - Fax:631-385-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5153208R261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
9C5871Medicare ID - Type Unspecified