Healthcare Provider Details

I. General information

NPI: 1306869763
Provider Name (Legal Business Name): GASTROENTEROLOGY ASSOCIATES OF PLATTSBURGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 PLAZA BLVD SUITE 101
PLATTSBURGH NY
12901-6438
US

IV. Provider business mailing address

77 PLAZA BLVD SUITE 101
PLATTSBURGH NY
12901-6438
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-7171
  • Fax: 518-562-7474
Mailing address:
  • Phone: 518-562-7171
  • Fax: 518-562-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. EUGENE CASSONE
Title or Position: PRESIDENT
Credential: MD
Phone: 518-562-7171