Organization
INTEGRATIVE MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA SCHNEIDER M.D. (INCORPORATOR)
(212) 217-1516
Entity
Organization
Contact information
Practice address
30 W 63RD ST, SUITE 12 N, NEW YORK, NY 10023-7103
(212) 217-1516
Mailing address
30 W 63RD ST, SUITE 12 N, NEW YORK, NY 10023-7103
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
215559
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02195384
—
NY
01
—
595BV1
EMPIRE BCBS
NY
Enumeration date
03/19/2007
Last updated
08/22/2020
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