Provider Demographics
NPI:1912905605
Name:GASTROINTESTINAL CONSULTANTS OF NEPA
Entity Type:Organization
Organization Name:GASTROINTESTINAL CONSULTANTS OF NEPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-969-6100
Mailing Address - Street 1:517 ASH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2903
Mailing Address - Country:US
Mailing Address - Phone:570-969-6100
Mailing Address - Fax:570-983-0267
Practice Address - Street 1:517 ASH ST
Practice Address - Street 2:STE 1
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-2903
Practice Address - Country:US
Practice Address - Phone:570-969-6100
Practice Address - Fax:570-983-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty