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Organization

WEST SIDE GI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINE FRASCO (DIRECTOR, HUMAN RESOURCES)
(212) 889-3142
Entity
Organization

Contact information

Practice address
619 W 54TH ST, 8TH FLOOR, NEW YORK, NY 10019-3545
(212) 874-3384
(646) 873-6600
Mailing address
619 W 54TH ST, 8TH FLOOR, NEW YORK, NY 10019-3545
(212) 874-3384
(646) 873-6600

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
192097
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A300077871
MEDICARE PTAN
NY
Enumeration date
03/07/2012
Last updated
01/07/2020
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