Organization
INTEGRA MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LADAN BAHRAMPOUR (MD)
(201) 447-7348
Entity
Organization
Contact information
Practice address
1124 E RIDGEWOOD AVE, SUITE 103, RIDGEWOOD, NJ 07450-3915
(201) 447-7348
Mailing address
PO BOX 741, FRANKLIN LAKES, NJ 07417-0741
(973) 476-7527
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07654700
NJ
Other
Enumeration date
09/26/2011
Last updated
11/03/2014
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