Provider Demographics
NPI:1003501826
Name:IM CARE FAMILY HEALTH NP PC
Entity Type:Organization
Organization Name:IM CARE FAMILY HEALTH NP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELNIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-864-8208
Mailing Address - Street 1:3974 AMBOY RD STE 302
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2414
Mailing Address - Country:US
Mailing Address - Phone:718-967-1071
Mailing Address - Fax:
Practice Address - Street 1:3974 AMBOY RD STE 302
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2414
Practice Address - Country:US
Practice Address - Phone:718-967-1071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care