DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC – NPI #1053505511
Clinic/Center

DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC is an AHC clinic located in LIVERPOOL, NY. NPPES has assigned the NPI number 1053505511 to DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC on August 28, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 11 years ago on Aug 25, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC below.

NPI Profile for
DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC

NPI Number
1053505511
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC
Primary location
5112 W TAFT RD
SUITE E
LIVERPOOL, NY 13088-4868
Phone: (315) 410-7400 Fax: (315) 458-4183
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LAUREEN KEEGAN
ADMINISTRATOR
Phone: (315) 410-7400
Updated
Identifiers

Identifiers for DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNY02966690
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.