Provider Demographics
NPI:1265216873
Name:IBIS HEALTH SERVICES - NORTH CAROLINA, PLLC
Entity type:Organization
Organization Name:IBIS HEALTH SERVICES - NORTH CAROLINA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OF MSO (SENSCIO SYSTEMS)
Authorized Official - Prefix:DR
Authorized Official - First Name:PIALI
Authorized Official - Middle Name:
Authorized Official - Last Name:DE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-834-2853
Mailing Address - Street 1:215 AYER RD UNIT 797
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-5033
Mailing Address - Country:US
Mailing Address - Phone:978-635-9090
Mailing Address - Fax:207-401-2727
Practice Address - Street 1:176 MINE LAKE CT STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6417
Practice Address - Country:US
Practice Address - Phone:908-230-4612
Practice Address - Fax:207-401-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty