Provider Demographics
NPI:1740455963
Name:HUNTINGTON GASTROENTEROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:HUNTINGTON GASTROENTEROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LODATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-421-2185
Mailing Address - Street 1:152 E MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2958
Mailing Address - Country:US
Mailing Address - Phone:631-421-2185
Mailing Address - Fax:631-421-3741
Practice Address - Street 1:152 E MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2958
Practice Address - Country:US
Practice Address - Phone:631-421-2185
Practice Address - Fax:631-421-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty