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Organization
TRIBOROUGH GASTROENTEROLOGY PC
Active
Organization
TRIBOROUGH GASTROENTEROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE JOHN OTTAVIANO MD (OWNER)
(212) 655-7310
Entity
Organization
Contact information
Practice address
5314 ROOSEVELT AVE, WOODSIDE, NY 11377-4239
(212) 655-7312
Mailing address
303 5TH AVE, SUITE 1205, NEW YORK, NY 10016-6601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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