Provider Demographics
NPI:1215224365
Name:INTEGRATED CLINICAL SERVICES
Entity Type:Organization
Organization Name:INTEGRATED CLINICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-844-5600
Mailing Address - Street 1:3085 HARLEM RD
Mailing Address - Street 2:STE 350
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2591
Mailing Address - Country:US
Mailing Address - Phone:716-844-5600
Mailing Address - Fax:716-844-5750
Practice Address - Street 1:3085 HARLEM RD
Practice Address - Street 2:STE 350
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2591
Practice Address - Country:US
Practice Address - Phone:716-844-5600
Practice Address - Fax:716-844-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty