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
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/16/2017
Last updated
03/17/2017
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