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General NPI Number Information
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NPI Number | 1285977975
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL AND LIVER CARE GROUP PLLC
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 688 WHITE PLAINS RD SUITE 222
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City | SCARSDALE
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State | NY
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Zip | 10583-5059
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Country | US
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Telephone | 914-725-9115
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Fax | 914-725-3465
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Provider Business Mailing Address
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Address Line | 688 WHITE PLAINS RD SUITE 222
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City | SCARSDALE
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State | NY
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Zip | 10583-5059
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Country | US
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Telephone | 914-725-9115
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Fax | 914-725-3465
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES COSTABILE DILORENZO
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Credential | MD
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Telephone | 914-725-9115
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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 |
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License Number State |
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