OrganizationActive
189-04 Facility Inc
NPI 1538567730 · Gastroenterology Physician · Fresh Meadows, NY
Provider details
- NPI number
- 1538567730
- Entity type
- Organization
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Allen Antonelli, President(718) 217-1414
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
18904 Union Tpke
Suite B
Fresh Meadows, NY 11366-1862
Phone: (718) 271-1414
Approximate (ZIP-level) locationGet directions
Mailing address
18904 Union Tpke
Fresh Meadows, NY 11366-1862
Registry dates
- Enumerated
- 2014-12-21
- Last updated
- 2014-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.