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Organization

INTEGRATED MEDICAL PROFESSIONALS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEEPAK KAPOOR MD (PRESIDENT)
(516) 931-0041
Entity
Organization

Contact information

Practice address
1 HOLLOW LANE, SUITE 206, LAKE SUCCESS, NY 11042
(516) 931-0041
(516) 822-1686
Mailing address
1 HOLLOW LANE, SUITE 206, LAKE SUCCESS, NY 11042
(516) 931-0041
(516) 822-1686

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2085R0001X
Radiation Oncology Physician
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02823018
NY
Enumeration date
04/10/2006
Last updated
12/29/2023
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