Healthcare Provider Details

I. General information

NPI: 1255352084
Provider Name (Legal Business Name): GASTROINTESTINAL AND HEPATOBILIARY CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NYMC-MUNGER PAVILION SUITE 206
VALHALLA NY
10595
US

IV. Provider business mailing address

NYMC-MUNGER PAVILION SUITE 206
VALHALLA NY
10595
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7337
  • Fax: 914-594-4317
Mailing address:
  • Phone: 914-493-7337
  • Fax: 914-594-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD LEBOVICS
Title or Position: PRESIDENT
Credential: MD
Phone: 914-493-7337