MEDICARE: EMPIRE GASTROENTEROLOGY PLLC

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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1669366233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPIRE GASTROENTEROLOGY PLLC

Provider Business Mailing Address
First Line	:	495 FORT WASHINGTON AVE STE PE1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4626
Country	:	US
Telephone Number	:	212-795-1021
Fax Number	:

Provider Business Practice Location Address
First Line	:	495 FORT WASHINGTON AVE STE PE1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4626
Country	:	US
Telephone Number	:	212-795-1021
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LINCOLN HERNANDEZ
Credential	:	MD
Telephone Number	:	212-795-1021

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	06/06/2025

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