Gastroenterology Associates of Northern New York PC

Organization Active NPI Gastroenterology Physician · Glens Falls, NY

NPI 1376583641 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1376583641
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF NORTHERN NEW YORK PC
Practice address
5 Irongate Center
Glens Falls, NY 12801
Phone
(518) 793-5034
Fax
(518) 793-2951
NPI assigned
Jun 7, 2006
Organization subpart
No

Authorized official

Name
Dr. Kevin J Herlihy, MD
Title
President
Phone
(518) 793-5034

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041116000388 NY Part B Supplier - Clinic/Group Practice 9032173430 Receives reassigned benefits from 11 practitioners
Practice locations: Fort Edward, NY; Glens Falls, NY

National Provider Directory

Locations

1391 Route 9
Fort Edward, NY 12828
Phone (518) 793-0891

5 Irongate Ctr
Glens Falls, NY 12801
Phone (518) 745-5423

6 Carpenter Ln
Saratoga Springs, NY 12866
Phone (518) 583-0020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RG0100X Yes

Addresses

Primary practice location

5 Irongate Center
Glens Falls, NY 12801

Mailing address

5 Irongate Center
Glens Falls, NY 12801
Phone (518) 793-5034

Other providers in Glens Falls, NY

All providers in Glens Falls, NY · Gastroenterology Physician in New York

Sources for this page

Verify at the official NPI Registry.