Provider Demographics
NPI:1396985990
Name:INNOVATIVE MEDICAL SOLUTIONS NY PC
Entity type:Organization
Organization Name:INNOVATIVE MEDICAL SOLUTIONS NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:INDERPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-410-4497
Mailing Address - Street 1:43 WHITTIER DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1016
Mailing Address - Country:US
Mailing Address - Phone:516-410-4497
Mailing Address - Fax:516-629-6712
Practice Address - Street 1:26619 UNION TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1426
Practice Address - Country:US
Practice Address - Phone:718-347-0434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty