Healthcare Provider Details

I. General information

NPI: 1275500159
Provider Name (Legal Business Name): GASTROINTESTINAL ASSOCIATES OF LONG ISLAND, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 04/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 MARCUS AVE SUITE 101
NEW HYDE PARK NY
11042-2058
US

IV. Provider business mailing address

1991 MARCUS AVE SUITE 101
NEW HYDE PARK NY
11042-2058
US

V. Phone/Fax

Practice location:
  • Phone: 516-365-4949
  • Fax: 516-365-5462
Mailing address:
  • Phone: 516-365-4949
  • Fax: 516-365-5462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANTHONY CELIFARCO
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 516-365-4949