Basic Information
| Provider Information | |||||||||
| NPI: | 1396985990 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INNOVATIVE MEDICAL SOLUTIONS NY PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 WHITTIER DR | ||||||||
| Address2: | |||||||||
| City: | ALBERTSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115071016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164104497 | ||||||||
| FaxNumber: | 5166296712 | ||||||||
| Practice Location | |||||||||
| Address1: | 26619 UNION TPKE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110401426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183470434 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 02/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHHABRA | ||||||||
| AuthorizedOfficialFirstName: | INDERPAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5164104497 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 220535 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.