MEDICARE: IMAC NP IN FAMILY HEALTH 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1831058049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAC NP IN FAMILY HEALTH PLLC

Provider Business Mailing Address
First Line	:	10415 101ST AVE
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-2702
Country	:	US
Telephone Number	:	646-401-1115
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 CORSA ST
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6624
Country	:	US
Telephone Number	:	646-401-1115
Fax Number	:

Authorized Official
Title or Position	:	MANAGER MEMBER
Name	:	MR. IFTIKHAR CHEEMA
Credential	:	PMHNP-BC
Telephone Number	:	646-401-1115

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/24/2026

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