Organization
DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREEN KEEGAN RN MSN (ADMINISTRATOR)
(315) 410-7400
Entity
Organization
Contact information
Practice address
5112 W TAFT RD, SUITE E, LIVERPOOL, NY 13088-4868
(315) 410-7400
(315) 458-4183
Mailing address
5112 W TAFT RD, SUITE E, LIVERPOOL, NY 13088-4868
(315) 410-7400
(315) 458-4183
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02966690
—
NY
Enumeration date
08/28/2007
Last updated
08/25/2015
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