Healthcare Provider Details

I. General information

NPI: 1003088394
Provider Name (Legal Business Name): AUSTIN MEDICAL OBS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 AUSTIN ST SUITE 101
FOREST HILLS NY
11375-4763
US

IV. Provider business mailing address

7010 AUSTIN ST SUITE 101
FOREST HILLS NY
11375-4763
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-9500
  • Fax: 718-793-8407
Mailing address:
  • Phone: 718-830-9500
  • Fax: 718-793-8407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number162939
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID J SOSNOWIK
Title or Position: CFO
Credential: MD
Phone: 718-830-9500