Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1235395369 |
| LBN Legal business name | 2116 KINGS HIGHWAY GI PLLC |
| Authorized official | BHARAT SANGHAVI - (MEDICAL DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/29/2008 |
| Last updated | 07/29/2008 - About 18 years ago |
| Identifiers | n/a |
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2116 KINGS HIGHWAY GI PLLC
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