Healthcare Provider Details

I. General information

NPI: 1780792119
Provider Name (Legal Business Name): ATLANTIC GASTROENTEROLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2797 OCEAN PKWY 3RD FLOOR
BROOKLYN NY
11235-7861
US

IV. Provider business mailing address

2797 OCEAN PKWY STE 1
BROOKLYN NY
11235-7868
US

V. Phone/Fax

Practice location:
  • Phone: 718-615-4001
  • Fax: 718-615-4004
Mailing address:
  • Phone: 718-615-4001
  • Fax: 718-615-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number239090
License Number StateNY

VIII. Authorized Official

Name: ALEXANDER SHAPSIS
Title or Position: PRESIDENT
Credential: MD
Phone: 718-615-4001