Active NPI
Digestive Liver Disease PC
- Gastroenterology Physician
- Staten Island, NY
National Provider Identifier
1669418364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0994990 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
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.