Healthcare Provider Details

I. General information

NPI: 1275763906
Provider Name (Legal Business Name): INTEGRATED NEUROLOGICAL ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 4TH AVENUE
BROOKLYN NY
11209
US

IV. Provider business mailing address

9201 4TH AVENUE
BROOKLYN NY
11209
US

V. Phone/Fax

Practice location:
  • Phone: 718-748-5300
  • Fax: 718-748-0920
Mailing address:
  • Phone: 718-748-5300
  • Fax: 718-748-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DAVID LIFSCHUTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 718-748-5300