Gastro 2020 PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

GASTRO 2020 PLLC

Practice address

9618 Metropolitan Ave
Forest Hills, NY 11375-6625

Phone

(516) 487-0360

NPI assigned

Oct 7, 2020

Organization subpart

No

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

Authorized official

Name

Edna Khodadadian, MD

Title

Owner

Phone

(516) 659-5229

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1326645870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 LIGHTHOUSE RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241140",
            "telephone_number": "516-659-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9618 METROPOLITAN AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756625",
            "telephone_number": "516-487-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO 2020 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "KHODADADIAN",
        "authorized_official_first_name": "EDNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-659-5229",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Liliana Garzon Velandia
• Ruby Judith Maloco Garzon, NP
• Richard A Gasalberti, MD
• Tyisha Gaskin
• Garik Gasparyan, MD
• Gastroenterology & Liver Disease, PC
• Gastroenterology & Nutrition, PC
• Fatima Gaton
• Israel Gavrielov
• Linda Gavrielov, RD

• Gastroenterology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.