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General NPI Number Information
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NPI Number | 1841562758
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Entity Type | Organization
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Legal Business Name | AAA GASTROINTESTINAL PC
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 499 FORT WASHINGTON AVE SUITE PE1C
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City | NEW YORK
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State | NY
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Zip | 10033
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Country | US
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Telephone | 646-599-0728
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Fax | 646-576-8625
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Provider Business Mailing Address
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Address Line | 499 FORT WASHINGTON AVE SUITE PE1C
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City | NEW YORK
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State | NY
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Zip | 10033-4609
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Country | US
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Telephone | 212-795-1021
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Fax | 212-795-1002
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINCOLN HERNANDEZ
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Credential | MD
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Telephone | 212-795-1021
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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 | 170703
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License Number State | NY
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