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General NPI Number Information
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NPI Number | 1083962948
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Entity Type | Organization
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Legal Business Name | ADVANCED AMBULATORY ENDOSCOPY PLLC
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 86 BOWERY 7TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10013-4615
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Country | US
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Telephone | 212-775-8388
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Fax |
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Provider Business Mailing Address
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Address Line | 86 BOWERY 7TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10013-4615
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Country | US
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Telephone | 212-775-8388
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Fax | 212-775-8383
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. TIMOTHY WONG
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Credential | M.D.
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Telephone | 917-535-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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