Provider Demographics
NPI:1275533895
Name:INTEGRATIVE MEDICAL CARE PC
Entity Type:Organization
Organization Name:INTEGRATIVE MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-856-8550
Mailing Address - Street 1:22 HAMILTON WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-1015
Mailing Address - Country:US
Mailing Address - Phone:203-856-8550
Mailing Address - Fax:888-417-9343
Practice Address - Street 1:22 HAMILTON WAY
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-1015
Practice Address - Country:US
Practice Address - Phone:203-856-8550
Practice Address - Fax:888-417-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEG221Medicare PIN
NY05853Medicare PIN