Provider Demographics
NPI:1447456652
Name:BROOKHAVEN GASTROENTEROLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:BROOKHAVEN GASTROENTEROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-289-2716
Mailing Address - Street 1:260 PATCHOGUE YAPHANK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:E PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4886
Mailing Address - Country:US
Mailing Address - Phone:631-289-0300
Mailing Address - Fax:631-289-0402
Practice Address - Street 1:260 PATCHOGUE YAPHANK RD
Practice Address - Street 2:SUITE C
Practice Address - City:E PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4886
Practice Address - Country:US
Practice Address - Phone:631-289-0300
Practice Address - Fax:631-289-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty