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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