1942697727 NPI number — RS GASTROENTEROLOGY, LLC

Table of content: (NPI 1942697727)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942697727 NPI number — RS GASTROENTEROLOGY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RS GASTROENTEROLOGY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942697727
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COND LA CORUNA CARR 177
Provider Second Line Business Mailing Address:
APT. 2503
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-884-7218
Provider Business Mailing Address Fax Number:
787-761-5764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COND LA CORUNA CARR 177
Provider Second Line Business Practice Location Address:
APT 2503
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-884-7218
Provider Business Practice Location Address Fax Number:
787-761-5764
Provider Enumeration Date:
04/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SOJO-ALTIERI
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-884-7218

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  17927 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 17927 . This is a "MEDICAL LICENCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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