Provider Demographics
NPI:1801404215
Name:INTEGRATIVE INTERVENTIONS LLC
Entity Type:Organization
Organization Name:INTEGRATIVE INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALOGIANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-656-4696
Mailing Address - Street 1:154 TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-2014
Mailing Address - Country:US
Mailing Address - Phone:917-656-4696
Mailing Address - Fax:
Practice Address - Street 1:154 TRENTON AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-2014
Practice Address - Country:US
Practice Address - Phone:917-656-4696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health