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General NPI Number Information
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NPI Number | 1194127373
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Entity Type | Organization
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Legal Business Name | AIM INTEGRATED MEDICINE
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 80 CROSSWAYS PARK DRIVE SUITE 200
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City | WOODBURY
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State | NY
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Zip | 11797
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Country | US
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Telephone | 516-802-5028
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Fax |
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Provider Business Mailing Address
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Address Line | 80 CROSSWAYS PARK DRIVE SUITE 200
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City | WOODBURY
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State | NY
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Zip | 11797
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Country | US
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Telephone | 516-802-5028
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL ELICE
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Credential | MD
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Telephone | 516-802-5028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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