Provider Demographics
NPI:1699186411
Name:INTEGRATED MEDICAL CARE
Entity Type:Organization
Organization Name:INTEGRATED MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:D'AMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-915-2131
Mailing Address - Street 1:4711 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3209
Mailing Address - Country:US
Mailing Address - Phone:347-915-2131
Mailing Address - Fax:347-915-2134
Practice Address - Street 1:4711 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3209
Practice Address - Country:US
Practice Address - Phone:347-915-2131
Practice Address - Fax:347-915-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty