Organization
INTEGRATED MEDICAL HEALTH CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARVEY WIEDER M.D. (PRESIDENT)
(631) 366-3334
Entity
Organization
Contact information
Practice address
624 TOWNLINE RD, HAUPPAUGE, NY 11788-2821
(631) 366-3334
(631) 366-3233
Mailing address
624 TOWNLINE RD, HAUPPAUGE, NY 11788-2821
(631) 366-3334
(631) 366-3233
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
206669
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01797382
—
NY
01
—
2007635
UNITED HEALTHCARE
NY
01
—
477164
PHCS
NY
01
—
5904677
GHI - GROUP HEALTH INC
NY
01
—
6138162-007
CIGNA HEALTHCARE
NY
01
—
AA70462
MDNY
NY
01
—
OD2081
EMPIRE BCBS
NY
01
—
P2370468
OXFORD
NY
01
—
SF-0002620
SELECT PRO
NY
Enumeration date
01/09/2007
Last updated
08/22/2020
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