Healthcare Provider Details

I. General information

NPI: 1144008525
Provider Name (Legal Business Name): RFELINTERGRATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 WILLOUGHBY ST APT 3S
BROOKLYN NY
11201-7588
US

IV. Provider business mailing address

196 WILLOUGHBY ST APT 3S
BROOKLYN NY
11201-7588
US

V. Phone/Fax

Practice location:
  • Phone: 917-349-0220
  • Fax:
Mailing address:
  • Phone: 917-349-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. REYNALDO FERNANDEZ
Title or Position: MANAGEMENT
Credential: RVT
Phone: 917-349-0220