Provider Demographics
NPI:1023364353
Name:INTREGRATED MEDICAL SERVICES OF LONG ISLAND ,PC
Entity Type:Organization
Organization Name:INTREGRATED MEDICAL SERVICES OF LONG ISLAND ,PC
Other - Org Name:MID ISLAND MULTI MEDICINE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-314-3344
Mailing Address - Street 1:2900 HEMPSTEAD TPKE
Mailing Address - Street 2:#203
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1404
Mailing Address - Country:US
Mailing Address - Phone:516-731-0303
Mailing Address - Fax:516-731-6302
Practice Address - Street 1:2900 HEMPSTEAD TPKE
Practice Address - Street 2:#203
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1404
Practice Address - Country:US
Practice Address - Phone:516-731-0303
Practice Address - Fax:516-731-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194295261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation