Healthcare Provider Details
I. General information
NPI: 1376599902
Provider Name (Legal Business Name): GASTROINTESTINAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1095 RYDAL RD SUITE 100
RYDAL PA
19046-1711
US
IV. Provider business mailing address
1095 RYDAL RD SUITE 100
RYDAL PA
19046-1711
US
V. Phone/Fax
- Phone: 267-620-1100
- Fax: 215-572-1279
- Phone: 267-620-1100
- Fax: 215-572-1279
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: MRS.
HELEN
P
ROSENTHAL
Title or Position: EXECUTIVE DIRECTOR
Credential: RN,CGRN
Phone: 267-620-1122