Healthcare Provider Details

I. General information

NPI: 1619871589
Provider Name (Legal Business Name): THE ENDOSCOPY CENTER OF QUEENS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 31ST ST STE 200
ASTORIA NY
11105-2298
US

IV. Provider business mailing address

2325 31ST ST STE 200
ASTORIA NY
11105-2298
US

V. Phone/Fax

Practice location:
  • Phone: 718-932-1234
  • Fax:
Mailing address:
  • Phone: 718-932-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: YVONNE BASKIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-932-1234