Basic Information
| Provider Information | |||||||||
| NPI: | 1932572880 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROOKLYN GASTROENTEROLOGY AND HEPATOLOGY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2315 86TH ST | ||||||||
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| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112144309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183330093 | ||||||||
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| Address1: | 2315 86TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112144309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183330093 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2015 | ||||||||
| LastUpdateDate: | 04/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | CHU | ||||||||
| AuthorizedOfficialFirstName: | POCHENG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7188083431 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 257725 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.