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General NPI Number Information
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NPI Number | 1265571863
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL CARE OF LONG ISLAND PLLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 187 VETERANS BLVD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-4982
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Country | US
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Telephone | 516-795-5523
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Fax | 516-795-5521
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Provider Business Mailing Address
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Address Line | 187 ROUTE 36 STE 230
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1306
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Country | US
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Telephone | 732-702-1039
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Fax | 732-548-7408
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Authorized Official
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Title or Position | RCM OPERATIONS MANAGER
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Name | JEAN M PFEIFLE
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Credential |
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Telephone | 640-333-0304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 151369-1
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License Number State | NY
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