Provider Demographics
NPI:1356028138
Name:GI DIGITAL INC
Entity type:Organization
Organization Name:GI DIGITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:332-245-3322
Mailing Address - Street 1:107 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2472
Mailing Address - Country:US
Mailing Address - Phone:914-500-8949
Mailing Address - Fax:
Practice Address - Street 1:535 5TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-8020
Practice Address - Country:US
Practice Address - Phone:332-245-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty