MEDICARE: INTEGRATED MEDICAL PROFESSIONALS PLLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1518723717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED MEDICAL PROFESSIONALS PLLC

Provider Business Mailing Address
First Line	:	1 HOLLOW LN STE 206
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1215
Country	:	US
Telephone Number	:	516-931-0041
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 LEXINGTON AVE FL 21
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6023
Country	:	US
Telephone Number	:	212-686-9015
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEEPAK KAPOOR
Credential	:	MD
Telephone Number	:	516-931-0041

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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