Healthcare Provider Details

I. General information

NPI: 1144225616
Provider Name (Legal Business Name): NASSAU GASTROENTEROLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NORTHERN BLVD STE 140
GREAT NECK NY
11021-5312
US

IV. Provider business mailing address

1000 NORTHERN BLVD STE 140
GREAT NECK NY
11021-5312
US

V. Phone/Fax

Practice location:
  • Phone: 516-466-2340
  • Fax: 516-829-6421
Mailing address:
  • Phone: 516-466-2340
  • Fax: 516-829-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SEYMOUR KATZ
Title or Position: OWNER
Credential: M.D.
Phone: 516-466-2340