Organization
ENDOSCOPIC DIAGNOSTIC & TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DOWD (OFFICE MANAGER)
(718) 748-5219
Entity
Organization
Contact information
Practice address
560 BAY RIDGE PKWY, BROOKLYN, NY 11209-3310
(718) 748-5219
(718) 439-4873
Mailing address
560 BAY RIDGE PKWY, BROOKLYN, NY 11209-3310
(718) 748-5219
(718) 439-4873
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7001122R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02748561
—
NY
Enumeration date
07/16/2006
Last updated
08/16/2013
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