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General NPI Number Information
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NPI Number | 1063776664
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CARE LLC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 163 MADISON AVE #220-044
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7358
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Country | US
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Telephone | 908-380-0690
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Fax |
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Provider Business Mailing Address
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Address Line | 163 MADISON AVE #220-044
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7358
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Country | US
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Telephone | 908-380-0690
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LINDA COMPAGNONE
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Credential | M.D.
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Telephone | 908-380-0690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA04932600
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License Number State | NJ
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