Provider Demographics
NPI:1083181523
Name:A & S MEDICAL, LLC
Entity type:Organization
Organization Name:A & S MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:GENAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-991-2565
Mailing Address - Street 1:115 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3052
Mailing Address - Country:US
Mailing Address - Phone:917-991-2565
Mailing Address - Fax:
Practice Address - Street 1:30 W 138TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1710
Practice Address - Country:US
Practice Address - Phone:212-690-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty