Provider Demographics
NPI:1598220857
Name:INTEGRATED MEDICAL SERVICES NY PLLC
Entity type:Organization
Organization Name:INTEGRATED MEDICAL SERVICES NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAGHAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-536-5765
Mailing Address - Street 1:180 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4704
Mailing Address - Country:US
Mailing Address - Phone:516-996-5900
Mailing Address - Fax:516-992-8373
Practice Address - Street 1:180 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4704
Practice Address - Country:US
Practice Address - Phone:516-996-5900
Practice Address - Fax:516-992-8373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty