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General NPI Number Information
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NPI Number | 1760964001
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH ADMINISTRATIVE SERVICES, INC.
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 1011 HOPE ST OFC E
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City | STAMFORD
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State | CT
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Zip | 06907-2121
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Country | US
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Telephone | 203-569-7651
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Fax | 914-777-8304
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Provider Business Mailing Address
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Address Line | 141 HALSTEAD AVE STE 304
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City | MAMARONECK
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State | NY
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Zip | 10543-2652
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Country | US
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Telephone | 914-777-8300
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Fax | 914-777-8304
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Authorized Official
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Title or Position | CHAIRMAN
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Name | LEONARD J TANZER
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Credential |
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Telephone | 914-777-8300
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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 | 2335203
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License Number State | CT
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