East Side Gastroenterology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

147236 Issued in NY

Legal business name

EAST SIDE GASTROENTEROLOGY, P.C.

Practice address

111 E 80TH St
1C
New York, NY 10021-0334

Phone

(212) 734-5533

Fax

(212) 717-1688

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Shanta Liverman, CMA

Title

Assistant

Phone

(212) 734-5533

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295958841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 80TH ST",
            "address_2": "1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210334",
            "telephone_number": "212-734-5533",
            "fax_number": "212-717-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 80TH ST",
            "address_2": "1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210334",
            "telephone_number": "212-734-5533",
            "fax_number": "212-717-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE GASTROENTEROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIVERMAN",
        "authorized_official_first_name": "SHANTA",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "212-734-5533",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "147236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Side Dermatology Services PC
• East Side Endocrine PLLC
• East Side Endoscopy LLC
• East Side Esda Inc D/B/a East Side Dental Arts
• East Side Foot Care PC
• East Side Medical & Cardiovascular Associates, P.C.
• East Side Medical and Diagnostics Services, PC
• East Side Medical Radiology PLLC
• East Side Medical, P.C.
• East Side Oncology Associates PLLC Dba American Infusion Center

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.