Basic Information
| Provider Information | |||||||||
| NPI: | 1811312689 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GASTROENTEROLOGY ASSOC. OF YORK, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2690 SOUTHFIELD DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174034510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177411414 | ||||||||
| FaxNumber: | 7177414774 | ||||||||
| Practice Location | |||||||||
| Address1: | 2690 SOUTHFIELD DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174034510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177411414 | ||||||||
| FaxNumber: | 7177414774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2014 | ||||||||
| LastUpdateDate: | 03/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | GILL | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7177411414 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA056736 | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.