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Organization

GOTHAM GASTROENTEROLOGY, PLLC

Active
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Organization

GOTHAM GASTROENTEROLOGY, PLLC

Active
Other names
Digestive Disease Laboratory
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER S KIM M.D. (MEDICAL DIRECTOR)
(212) 794-0240
Entity
Organization

Contact information

Practice address
535 5TH AVE, NEW YORK, NY 10017-3620
(212) 570-2075
Mailing address
1317 3RD AVE, NEW YORK, NY 10021-2995

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
190910
NY

Other

Enumeration date
04/18/2014
Last updated
04/18/2014
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