Organization
ENDO GROUP, LLC
Active
Other names
Garden City SurgiCenter
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY FITZPATRICK (ADMINISTRATOR)
(516) 832-8504
Entity
Organization
Contact information
Practice address
400 ENDO BLVD, GARDEN CITY, NY 11530
(516) 832-8504
(516) 832-1085
Mailing address
400 ENDO BLVD, GARDEN CITY, NY 11530
(516) 832-8504
(516) 832-1085
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2905200R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003602
EMPIRE BCBS PROVIDER ID
NY
05
—
01088980
—
NY
01
—
14404
AETNA PROVIDER ID
NY
01
—
331007
HIP PROVIDER ID
NY
01
—
33C0001007
MEDICARE
NY
01
—
A382712
OXFORD PROVIDER ID
NY
01
—
IC0199
HEALTHNET PROVIDER ID
NY
Enumeration date
09/29/2006
Last updated
10/02/2015
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