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General NPI Number Information
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NPI Number | 1083330344
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTH SOLUTIONS
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 92 W HILL RD
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City | COLONIA
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State | NJ
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Zip | 07067-3811
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Country | US
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Telephone | 718-844-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 92 W HILL RD
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City | COLONIA
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State | NJ
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Zip | 07067-3811
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Country | US
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Telephone | 718-844-4333
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Fax |
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Authorized Official
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Title or Position | CEO/PARTNER
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Name | MARBEN CASEM BLANCO
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Credential |
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Telephone | 718-844-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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