Provider Demographics
NPI:1932820339
Name:TRIBOROUGH GI PLLC
Entity Type:Organization
Organization Name:TRIBOROUGH GI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-450-4870
Mailing Address - Street 1:1672 SHEEPSHEAD BAY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3803
Mailing Address - Country:US
Mailing Address - Phone:718-332-0600
Mailing Address - Fax:718-332-3262
Practice Address - Street 1:1672 SHEEPSHEAD BAY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3803
Practice Address - Country:US
Practice Address - Phone:718-332-0600
Practice Address - Fax:718-332-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory