Healthcare Provider Details

I. General information

NPI: 1215793427
Provider Name (Legal Business Name): INTEGRATED MEDICAL PROFESSIONALS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 OLD COUNTRY RD STE 8
PLAINVIEW NY
11803-5018
US

IV. Provider business mailing address

1 HOLLOW LN STE 206
NEW HYDE PARK NY
11042-1215
US

V. Phone/Fax

Practice location:
  • Phone: 516-933-6060
  • Fax:
Mailing address:
  • Phone: 516-931-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DEEPAK KAPOOR
Title or Position: CEO
Credential: MD
Phone: 516-931-0041