Healthcare Provider Details

I. General information

NPI: 1457673790
Provider Name (Legal Business Name): INTEGRAL MEDICAL PRACTICE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 E 105TH ST
BROOKLYN NY
11236-4606
US

IV. Provider business mailing address

1713 RALPH AVE
BROOKLYN NY
11236
US

V. Phone/Fax

Practice location:
  • Phone: 718-531-6100
  • Fax: 718-531-2329
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number197329
License Number StateNY

VIII. Authorized Official

Name: DR. JEAN DANIEL FRANCOIS
Title or Position: OWNER
Credential: M.D.
Phone: 718-531-6100