Provider Demographics
NPI:1821313594
Name:NEW YORK GASTROENTEROLOGY & DIGESTIVE DISORDERS PC
Entity type:Organization
Organization Name:NEW YORK GASTROENTEROLOGY & DIGESTIVE DISORDERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:I
Authorized Official - Last Name:FINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-885-0633
Mailing Address - Street 1:20 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1706
Mailing Address - Country:US
Mailing Address - Phone:917-885-0633
Mailing Address - Fax:201-261-4944
Practice Address - Street 1:20 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1706
Practice Address - Country:US
Practice Address - Phone:917-885-0633
Practice Address - Fax:201-261-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RG0100X
NY120476207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00313828Medicaid