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General NPI Number Information
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NPI Number | 1952845018
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Entity Type | Organization
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Legal Business Name | EW GASTRO C.S.P
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | URB CAUTIVA, 3 ALMACIGOS
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City | CAGUAS
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State | PR
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Zip | 00727
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Country | UM
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Telephone | 787-214-9163
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Fax | 787-761-5764
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Provider Business Mailing Address
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Address Line | LF 1 CALLE 32 URB VILLA DEL REY 5TA SECCION
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City | CAGUAS
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State | PR
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Zip | 00727
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Country | US
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Telephone | 787-214-9163
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Fax | 787-761-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EMANUEL WARRINGTON COLON
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Credential | M.D
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Telephone | 787-214-9163
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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 | 17848
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License Number State | PR
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