| Gastroenterology Care Of Li Pc | |
|
94 Gardiners Ave #334 Levittown NY 11756-3705 | |
| (631) 271-9151 | |
| (631) 271-9155 |
| Full Name | Gastroenterology Care Of Li Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 94 Gardiners Ave, Levittown, New York |
| Authorized Official Name and Position | Bernard Stark (OWNER) |
| Authorized Official Contact | 6312719151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Care Of Li Pc 94 Gardiners Ave #334 Levittown NY 11756-3705 Ph: (631) 271-9151 | Gastroenterology Care Of Li Pc 94 Gardiners Ave #334 Levittown NY 11756-3705 Ph: (631) 271-9151 |
| NPI Number | 1881009447 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 06/23/2014 |
| Medicare PECOS PAC ID | 0143447029 |
|---|---|
| Medicare Enrollment ID | O20140818000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881009447 | NPI | - | NPPES |
| 135237-1 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 135237-1 (New York) | Primary |
| Provider Name | Bernard Stark |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063572113 PECOS PAC ID: 6507824596 Enrollment ID: I20041222000100 |
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