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General NPI Number Information
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NPI Number | 1588938682
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Entity Type | Organization
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Legal Business Name | WEST SIDE GI, LLC
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 619 W 54TH ST 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-3545
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Country | US
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Telephone | 212-874-3384
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Fax | 646-873-6600
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Provider Business Mailing Address
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Address Line | 619 W 54TH ST 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-3545
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Country | US
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Telephone | 212-874-3384
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Fax | 646-873-6600
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Authorized Official
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Title or Position | DIRECTOR, HUMAN RESOURCES
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Name | CHRISTINE FRASCO
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Credential |
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Telephone | 212-889-3142
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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 | 192097
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License Number State | NY
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