MEDICARE: INTEGRATED TREATMENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		NY

General Provider Information

NPI Number	:	1144537432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED TREATMENT SERVICES

Provider Business Mailing Address
First Line	:	6010 NEW UTRECHT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5041
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6010 NEW UTRECHT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5041
Country	:	US
Telephone Number	:	718-431-8938
Fax Number	:

Authorized Official
Title or Position	:	FISCAL DIRECTOR
Name	:	MRS. YITTY KISH
Credential	:
Telephone Number	:	718-431-5938

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	07/21/2022

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