# EAST SUMMIT MEDICAL PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093371742
- **Authorized official:** KEVIN TIN (ADMINISTRATOR)
- **Authorized official phone:** (917) 336-8422

## Contact information

- **Practice address:** 40 BOWERY \# GROUND, NEW YORK, NY 10013-4801
- **Practice address phone:** (646) 609-6138
- **Mailing address:** 7116 GRAND AVE, MASPETH, NY 11378-1823
- **Mailing address phone:** (646) 609-6138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2019
- **Last updated:** 12/06/2022