Provider Demographics
NPI:1922189752
Name:INTEGRATIVE ONCOLOGY, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE ONCOLOGY, LLC
Other - Org Name:THE BOYD CENTER FOR INTEGRATIVE HEALTH, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-869-2111
Mailing Address - Street 1:15 VALLEY DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5205
Mailing Address - Country:US
Mailing Address - Phone:203-869-2111
Mailing Address - Fax:
Practice Address - Street 1:15 VALLEY DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5205
Practice Address - Country:US
Practice Address - Phone:203-869-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT27275207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03224Medicare PIN