Healthcare Provider Details

I. General information

NPI: 1316916307
Provider Name (Legal Business Name): GASTROENTEROLOGY ASSOC OF YORK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 SOUTHFIELD DR
YORK PA
17403-4510
US

IV. Provider business mailing address

2690 SOUTHFIELD DR
YORK PA
17403-4510
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-1414
  • Fax: 717-741-4774
Mailing address:
  • Phone: 717-741-1414
  • Fax: 717-741-4774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES M GILL
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 717-741-1414