Healthcare Provider Details
I. General information
NPI: 1265001838
Provider Name (Legal Business Name): COMPREHENSIVE GASTROINTESTINAL AND MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2021
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 WALL ST FL 20
NEW YORK NY
10005-2123
US
IV. Provider business mailing address
166 E 88TH ST STE 1
NEW YORK NY
10128-2255
US
V. Phone/Fax
- Phone: 347-298-4100
- Fax: 347-227-1368
- Phone: 212-410-3350
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
PULLANO
Title or Position: CEO/MEDICAL DIRECTOR
Credential: MD
Phone: 212-410-3350