MEDICARE: INTEGRATED MEDICAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	133V00000X	Registered Dietitian
3	183500000X	Pharmacist
4	225X00000X	Occupational Therapist
5	231H00000X	Audiologist
6	235Z00000X	Speech-Language Pathologist
7	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326500588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED MEDICAL HEALTH

Provider Business Mailing Address
First Line	:	522 E 9TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-5221
Country	:	US
Telephone Number	:	718-902-6859
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 E 9TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-5221
Country	:	US
Telephone Number	:	718-902-6859
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN NOROWITZ
Credential	:	MD
Telephone Number	:	718-435-5009

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	07/09/2019

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Directions to “INTEGRATED MEDICAL HEALTH ” Practice Location

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