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Organization
STEWARD MEDICAL GROUP PENNSYLVANIA ENDOSCOPY LLC
Active
Organization
STEWARD MEDICAL GROUP PENNSYLVANIA ENDOSCOPY LLC
Active
Other names
Twin Rivers Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY KOCH (CFO)
(617) 562-5359
Entity
Organization
Contact information
Practice address
77 WARREN ST, BRIGHTON, MA 02135-3601
(617) 562-5359
Mailing address
77 WARREN ST, BRIGHTON, MA 02135-3601
(617) 562-5359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/16/2017
Last updated
03/17/2017
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