Provider Demographics
NPI:1265574768
Name:ENDOSCOPY CENTER OF LONG ISLAND LLC
Entity type:Organization
Organization Name:ENDOSCOPY CENTER OF LONG ISLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARWIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-227-3254
Mailing Address - Street 1:711 STEWART AVENUE, SUITE 114
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-227-2354
Mailing Address - Fax:516-998-4078
Practice Address - Street 1:711 STEWART AVENUE, SUITE 114
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-227-2354
Practice Address - Fax:516-998-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02501655Medicaid
9C5911Medicare ID - Type Unspecified
NYA100001128Medicare PIN