| Digestive Diseases & Nutrition Llc | |
|
175 61 Hillside Ave Ste 402 Jamaica Estates NY 11432-5796 | |
| (718) 291-0488 | |
| (718) 291-0888 |
| Full Name | Digestive Diseases & Nutrition Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 175 61 Hillside Ave, Jamaica Estates, New York |
| Authorized Official Name and Position | Rom M Gupta (OWNER) |
| Authorized Official Contact | 5163306615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Diseases & Nutrition Llc 175 61 Hillside Ave Ste 402 Jamaica Estates NY 11432-5796 Ph: (516) 330-6615 | Digestive Diseases & Nutrition Llc 175 61 Hillside Ave Ste 402 Jamaica Estates NY 11432-5796 Ph: (718) 291-0488 |
| NPI Number | 1225208564 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 11/05/2020 |
| Medicare PECOS PAC ID | 1355230863 |
|---|---|
| Medicare Enrollment ID | O20091019000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225208564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 189770 (New York) | Primary |
| Provider Name | Huaibao Sheng |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942299516 PECOS PAC ID: 9133192156 Enrollment ID: I20040818000113 |
| Provider Name | Rom M Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013992528 PECOS PAC ID: 4789689795 Enrollment ID: I20060926000388 |
| Provider Name | Jean J Luo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679757892 PECOS PAC ID: 5597843276 Enrollment ID: I20080422000050 |
Mohammad Rahman Medical Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170-12 Highland Ave, Unit 101, Jamaica Estates, NY 11432 Phone: 718-526-0700 Fax: 718-526-0800 |