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General NPI Number Information
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NPI Number | 1972980845
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Entity Type | Organization
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Legal Business Name | INTEGRATED MEDICAL HEALTH SERVICES PC
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 100 LIVINGSTON ST STE 3
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City | BROOKLYN
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State | NY
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Zip | 11201-5023
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Country | US
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Telephone | 347-414-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 20215 46TH RD
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City | BAYSIDE
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State | NY
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Zip | 11361-3059
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Country | US
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Telephone | 347-414-3070
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CATHY DELERME PAGAN
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Credential | MD
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Telephone | 347-414-3070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 198983
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License Number State | NY
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