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General NPI Number Information
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NPI Number | 1326334988
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Entity Type | Organization
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Legal Business Name | MANHATTAN INTEGRATIVE MEDICINE, P.C.
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 1841 BROADWAY SUITE 1012
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City | NEW YORK
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State | NY
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Zip | 10023
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Country | US
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Telephone | 212-262-2412
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Fax |
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Provider Business Mailing Address
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Address Line | 1 IPSWICH AVE APT 104
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-220-2847
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Fax |
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | MRS. BEATA LEWANDOWSKI
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Credential |
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Telephone | 516-222-0036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 210699
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License Number State | NY
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