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Organization
INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC
Active
Organization
INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HASIB MIKAEL SARIJ MD (OWNER)
(516) 336-8659
Entity
Organization
Contact information
Practice address
1111 BROAD HOLLOW RD 110 SUITE 114, FARMINGDALE, NY 11735
(516) 336-8659
Mailing address
1111 BROAD HOLLOW RD 110 SUITE 114, FARMINGDALE, NY 11735
(516) 336-8659
(516) 253-2141
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
229328
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02549791
—
NY
Enumeration date
04/20/2016
Last updated
04/20/2016
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