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NPI Code Detail

MEDICARE: TWIN RIVERS ENDOSCOPY CENTER, INC

MEDICARE: TWIN RIVERS ENDOSCOPY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0800XEndoscopy Clinic/Center05711500PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1390821OTHERPACAPITAL BLUE CROSS
2393727OTHERPAHIGHMARK BLUE SHIELD
34972443OTHERPACIGNA
41001448OTHERPAAETNA
55110626OTHERPAAETNA PPO

General Provider Information

NPI Number : 1063465037
Entity Type Code : Organization
Provider Name (Legal Business Name) : TWIN RIVERS ENDOSCOPY CENTER, INC
Provider Business Mailing Address
First Line : 20 COMMUNITY DR
Second Line :
City : EASTON
State : PA
Zip : 18045-2658
Country : US
Telephone Number : 610-258-6635
Fax Number : 610-258-2879
Provider Business Practice Location Address
First Line : 20 COMMUNITY DR
Second Line :
City : EASTON
State : PA
Zip : 18045-2658
Country : US
Telephone Number : 610-258-6635
Fax Number : 610-258-2879
Authorized Official
Title or Position : CEO
Name : DR. SHANKER MUKHERJEE
Credential : M.D.
Telephone Number : 610-258-6635
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/22/2020

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Directions to “TWIN RIVERS ENDOSCOPY CENTER, INC ” Practice Location

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