Organization
ISLAND GASTROENTEROLOGY CONSULTANTS PC
Active
Organization
ISLAND GASTROENTEROLOGY CONSULTANTS PC
Active
Other names
Island Pathology Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJKUMAR G MARIWALLA MD (OWNER)
(631) 669-1171
Entity
Organization
Contact information
Practice address
631 MONTAUK HWY, WEST ISLIP, NY 11795-4400
(631) 806-5600
Mailing address
1111 MONTAUK HWY, WEST ISLIP, NY 11795-4910
(631) 669-1171
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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