Provider Demographics
NPI:1184715450
Name:BROOME GASTROENTEROLOGY ASSOC, PC
Entity type:Organization
Organization Name:BROOME GASTROENTEROLOGY ASSOC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HASSIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-729-1444
Mailing Address - Street 1:161 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-729-1444
Mailing Address - Fax:607-729-7086
Practice Address - Street 1:161 RIVERSIDE DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-729-1444
Practice Address - Fax:607-729-7086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01320745Medicaid
NY53369AMedicare ID - Type Unspecified