Healthcare Provider Details

I. General information

NPI: 1750363362
Provider Name (Legal Business Name): IMS CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 OLD COUNTRY RD STE 127
PLAINVIEW NY
11803-5015
US

IV. Provider business mailing address

1670 OLD COUNTRY RD STE 127
PLAINVIEW NY
11803-5015
US

V. Phone/Fax

Practice location:
  • Phone: 516-576-6114
  • Fax: 516-576-6115
Mailing address:
  • Phone: 516-576-6112
  • Fax: 516-576-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier00922418
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MR. PAUL M POLLICHINO
Title or Position: PRESIDENT
Credential: CO
Phone: 516-576-6114