Provider Demographics
NPI:1700658499
Name:TOP INTEGRATED MEDGROUP LLC
Entity Type:Organization
Organization Name:TOP INTEGRATED MEDGROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-743-7900
Mailing Address - Street 1:45 KNOLLWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 KNOLLWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2806
Practice Address - Country:US
Practice Address - Phone:914-743-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty