Provider Demographics
NPI:1184485666
Name:NEW YORK DIGESTIVE DISEASE CENTER ,LLC
Entity type:Organization
Organization Name:NEW YORK DIGESTIVE DISEASE CENTER ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAUMUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMNAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-321-0670
Mailing Address - Street 1:5514 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5005
Mailing Address - Country:US
Mailing Address - Phone:718-321-0670
Mailing Address - Fax:718-321-0099
Practice Address - Street 1:5514 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5005
Practice Address - Country:US
Practice Address - Phone:718-321-0670
Practice Address - Fax:718-321-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty