Organization · NPI-2

189-04 Facility INC

Internal Medicine, Gastroenterology · Fresh Meadows, NY

NPI number1538567730
StatusActive
Last updated in NPPESDec 21, 2014

Details

NPI
1538567730
Entity type
Organization (NPI-2)
Legal business name
189-04 Facility INC
Organization subpart
No
Enumeration date
Dec 21, 2014
Last updated
Dec 21, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RG0100X Internal Medicine, Gastroenterology––Yes

Practice location

18904 Union Tpke
Suite B
Fresh Meadows, NY 11366-1862

Phone 718-271-1414

Mailing address

18904 Union Tpke
Suite B
Fresh Meadows, NY 11366-1862

Phone 718-271-1414

Authorized official

Allen Antonelli
President
7182171414

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine, Gastroenterology providers in Fresh Meadows, NY