| Integra Medical Group Llc | |
|
1124 E Ridgewood Ave Suite 103 Ridgewood NJ 07450-3915 | |
| (201) 447-7348 | |
| Not Available |
| Full Name | Integra Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1124 E Ridgewood Ave, Ridgewood, New Jersey |
| Authorized Official Name and Position | Ladan Bahrampour (MD) |
| Authorized Official Contact | 2014477348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integra Medical Group Llc Po Box 741 Franklin Lakes NJ 07417-0741 Ph: (973) 476-7527 | Integra Medical Group Llc 1124 E Ridgewood Ave Suite 103 Ridgewood NJ 07450-3915 Ph: (201) 447-7348 |
| NPI Number | 1720361884 |
|---|---|
| Provider Enumeration Date | 09/26/2011 |
| Last Update Date | 11/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720361884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07654700 (New Jersey) | Primary |
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