MEDICARE: SAINT FRANCIS GI ENDOSCOPY L.L.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1558524298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT FRANCIS GI ENDOSCOPY L.L.C

Provider Business Mailing Address
First Line	:	360 BLOOMFIELD AVE
Second Line	:	SUITE 204
City	:	WINDSOR
State	:	CT
Zip	:	06095-2700
Country	:	US
Telephone Number	:	561-330-3381
Fax Number	:	561-330-3382

Provider Business Practice Location Address
First Line	:	360 BLOOMFIELD AVE
Second Line	:	SUITE 204
City	:	WINDSOR
State	:	CT
Zip	:	06095-2700
Country	:	US
Telephone Number	:	561-330-3381
Fax Number	:	561-330-3382

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	ELLEN M KELTING
Credential	:
Telephone Number	:	860-683-9991

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	05/06/2015

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