Provider Demographics
NPI:1669577318
Name:INTEGRATED HEALTHCARE GROUP, P.C.
Entity type:Organization
Organization Name:INTEGRATED HEALTHCARE GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VITIEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-866-3100
Mailing Address - Street 1:PO BOX 7664
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-7664
Mailing Address - Country:US
Mailing Address - Phone:201-866-3100
Mailing Address - Fax:201-866-0321
Practice Address - Street 1:5600 KENNEDY BLVD W
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1256
Practice Address - Country:US
Practice Address - Phone:201-866-3100
Practice Address - Fax:201-866-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0076911Medicaid
NJ0076911Medicaid