Organization
INTERCITY GASTROENTEROLOGY P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHULAMULLAH SHAHZAD (PRESIDENT)
(516) 784-8331
Entity
Organization
Contact information
Practice address
19303 UNION TPKE, FRESH MEADOWS, NY 11366-1874
(516) 721-4648
Mailing address
957 N 1ST ST, NEW HYDE PARK, NY 11040-2821
(516) 784-8331
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
252160
NY
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03190443
—
NY
Enumeration date
06/09/2017
Last updated
08/31/2022
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