Provider Demographics
NPI:1023272846
Name:GASTROENTEROLOGY AND LIVER ASSOCIATES OF RIVERDALE PC
Entity type:Organization
Organization Name:GASTROENTEROLOGY AND LIVER ASSOCIATES OF RIVERDALE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-796-1000
Mailing Address - Street 1:3333 HENRY HUDSON PKWY
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3224
Mailing Address - Country:US
Mailing Address - Phone:718-796-1000
Mailing Address - Fax:718-796-2124
Practice Address - Street 1:3333 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE # 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3224
Practice Address - Country:US
Practice Address - Phone:718-796-1000
Practice Address - Fax:718-796-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty