INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC NPI 1962856450

NPI Information

NPI: 1962856450
Provider Name: INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC
Classification: Registered Nurse - 163WP0000X
Entity Type: Organization

Specialization: Pain Management

CLIA Number: 33D2109963

Address:
1111 BROAD HOLLOW RD 110 SUITE 114
FARMINGDALE, NY
ZIP 11735
Phone: (516) 336-8659
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INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC is a pain management registered nurse in Farmingdale, NY. INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC NPI is 1962856450. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1111 BROAD HOLLOW RD 110 SUITE 114
FARMINGDALE, NY
ZIP 11735
Phone: (516) 336-8659

The provider's authorized official is Hasib Mikael Sarij .
The authorized official title is Owner and has the following contact phone number (516) 336-8659.

The CLIA number assigned to this NPI record is 33D2109963 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/20/2016 and was last updated on 4/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0000X	Registered Nurse	Pain Management	229328		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	02549791	MEDICAID	NEW YORK
2	WXWPR1	MEDICARE PIN
3	I07147	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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