Provider Demographics
NPI:1497952311
Name:INTELCARE MED LLC
Entity Type:Organization
Organization Name:INTELCARE MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:PELHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-772-2400
Mailing Address - Street 1:5 E 83RD ST
Mailing Address - Street 2:C/O FRANCIS PELHAM
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0401
Mailing Address - Country:US
Mailing Address - Phone:212-772-2400
Mailing Address - Fax:212-744-2492
Practice Address - Street 1:5 E 83RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0401
Practice Address - Country:US
Practice Address - Phone:212-772-2400
Practice Address - Fax:212-744-2492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183533261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty