Third Avenue Gastroenterology, P.C.

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

190910 Issued in NY

Legal business name

THIRD AVENUE GASTROENTEROLOGY, P.C.

Practice address

1317 3Rd Ave
9TH Floor
New York, NY 10021-2995

Phone

(212) 794-0240

Fax

(212) 570-2038

NPI assigned

Aug 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Sungwon Kim, M.D.

Title

President

Phone

(212) 794-0240

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1164679395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240",
            "fax_number": "212-570-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD AVENUE GASTROENTEROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SUNGWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-794-0240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NY",
            "license": "190910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endoscopy Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Endoscopy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.