Provider Demographics
NPI:1366613630
Name:INTEGRATED MEDICAL
Entity type:Organization
Organization Name:INTEGRATED MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MAMAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-924-7576
Mailing Address - Street 1:40 BAYARD LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3029
Mailing Address - Country:US
Mailing Address - Phone:609-924-7576
Mailing Address - Fax:
Practice Address - Street 1:161 MADISON AVE FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5438
Practice Address - Country:US
Practice Address - Phone:212-686-8689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty