Gotham Gastroenterology, PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

190910 Issued in NY

Legal business name

GOTHAM GASTROENTEROLOGY, PLLC

Practice address

1317 3Rd Ave
New York, NY 10021-2995

Phone

(212) 794-0240

Fax

(212) 570-2038

NPI assigned

Apr 23, 2010

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

Partner

Phone

(212) 794-0240

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1659698116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240",
            "fax_number": "212-570-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240",
            "fax_number": "212-570-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTHAM GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SUNGWON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "212-794-0240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "190910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in New York, NY
• Providers in New York, 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 Apr 23, 2010; 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.