Basic Information
| Provider Information | |||||||||
| NPI: | 1720254782 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MANHATTAN EAST ENDOSCOPY, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1317 3RD AVE FL 5 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100212955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127348811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1317 3RD AVE FL 5 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100212955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127348811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2008 | ||||||||
| LastUpdateDate: | 04/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | BAIOCCO | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO/MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2127348811 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
ID Information
| ID | Type | State | Issuer | Description | 457799 | 01 | NY | THE JOINT COMMISSION ID | OTHER |