| Integrated Triborough Medical, Pllc | |
|
1000 Northern Blvd Suite 175 Great Neck NY 11021-5338 | |
| (631) 271-9151 | |
| (631) 271-9155 |
| Full Name | Integrated Triborough Medical, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1000 Northern Blvd, Great Neck, New York |
| Authorized Official Name and Position | Perry Stevens (OWNER) |
| Authorized Official Contact | 6312719151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Triborough Medical, Pllc 1000 Northern Blvd Suite 175 Great Neck NY 11021-5338 Ph: (631) 271-9151 | Integrated Triborough Medical, Pllc 1000 Northern Blvd Suite 175 Great Neck NY 11021-5338 Ph: (631) 271-9151 |
| NPI Number | 1154769669 |
|---|---|
| Provider Enumeration Date | 06/06/2013 |
| Last Update Date | 06/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154769669 | NPI | - | NPPES |
| 179574 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 179574 (New York) | Primary |
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