MEDICARE: INTEGRAL MEDICAL PRACTICE, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	197329	NY

General Provider Information

NPI Number	:	1457673790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL MEDICAL PRACTICE, P.C.

Provider Business Mailing Address
First Line	:	1713 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1306 E 105TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4606
Country	:	US
Telephone Number	:	718-531-6100
Fax Number	:	718-531-2329

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEAN DANIEL FRANCOIS
Credential	:	M.D.
Telephone Number	:	718-531-6100

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	02/26/2010

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