Provider Demographics
NPI:1134658693
Name:INTERNAL MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-928-9355
Mailing Address - Street 1:21422 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2914
Mailing Address - Country:US
Mailing Address - Phone:718-464-4444
Mailing Address - Fax:718-347-4362
Practice Address - Street 1:243 BOYLE RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1929
Practice Address - Country:US
Practice Address - Phone:631-696-2000
Practice Address - Fax:631-696-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty