| Integrated Healthcare Group, P.c. | |
|
5600 Kennedy Blvd W West New York NJ 07093-1256 | |
| (201) 866-3100 | |
| Not Available |
| Full Name | Integrated Healthcare Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5600 Kennedy Blvd W, West New York, New Jersey |
| Authorized Official Name and Position | Ellen Vitievsky (OWNER) |
| Authorized Official Contact | 2018663100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Healthcare Group, P.c. Po Box 7664 North Brunswick NJ 08902-7664 Ph: (201) 866-3100 | Integrated Healthcare Group, P.c. 5600 Kennedy Blvd W West New York NJ 07093-1256 Ph: (201) 866-3100 |
| NPI Number | 1669577318 |
|---|---|
| Provider Enumeration Date | 09/14/2006 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 8123054855 |
|---|---|
| Medicare Enrollment ID | O20050722000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669577318 | NPI | - | NPPES |
| 0076911 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ellen Vitievsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366547135 PECOS PAC ID: 7315905270 Enrollment ID: I20050124000849 |
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