Organization Active NPI

Digestive Liver Disease PC

  • Gastroenterology Physician
  • Staten Island, NY
National Provider Identifier
1669418364
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE LIVER DISEASE PC
Practice address
5 Little Clove Road
Staten Island, NY 10301
Phone
(718) 876-9600
Fax
(718) 876-7773
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Authorized official

Name
Divyang Parikh, MD
Title
Owner
Phone
(718) 876-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5 Little Clove Road
Staten Island, NY 10301

Mailing address

5 Little Clove Road
Staten Island, NY 10301
Phone (718) 876-9600

Other identifiers 1

IdentifierTypeStateIssuer
0994990MedicaidNY

National Provider Directory

National Provider Directory

Locations

5 Little Clove Rd
Staten Island, NY 10301
Phone (718) 876-5146

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1669418364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LITTLE CLOVE ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-876-9600",
            "fax_number": "718-876-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LITTLE CLOVE ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-876-9600",
            "fax_number": "718-876-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE LIVER DISEASE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "PARIKH",
        "authorized_official_first_name": "DIVYANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-876-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0994990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.