- Practice location
- 758 61ST St, Brooklyn, NY 11220-4212
- Phone
- 718-522-1118
- Fax
- 212-335-0320
- Last updated
- June 12, 2020
Excelsior Integrated Medical Group, PLLC is a healthcare organization based in Brooklyn, NY. Excelsior Integrated Medical Group, PLLC practices in Brooklyn, NY. The NPI Number for Excelsior Integrated Medical Group, PLLC is 1881053775 and holds a License No. 250205 (NY). The current practice location address for Excelsior Integrated Medical Group, PLLC is 758 61ST St, Brooklyn, NY 11220-4212 and can be reached out via phone at 718-522-1118 and via fax at 212-335-0320.
Provider Profile Details
- NPI Number
- 1881053775
- Provider Name
- Excelsior Integrated Medical Group, PLLC
- Provider Entity Type
- Organization
- Address
- 758 61ST St, Brooklyn, NY 11220-4212
- Phone Number
- 718-522-1118
- Fax Number
- 212-335-0320
- Primary Taxonomy
- Clinic/Center, Radiology, Mammography · 261QR0206X
- Organization Subpart
- No
- Authorized Official
- George Hall, MD · President · 212-335-0328
- Other Names
- Healthier Imaging & Lab, INC (Doing Business As)
- Provider Enumeration Date
- February 19, 2016
- Last Update Date
- June 12, 2020
- Certification Date
- June 12, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 758 61ST St
Brooklyn, NY 11220-4212 - City
- Brooklyn
- State
- New York
- Zip
- 11220-4212
- Phone Number
- 718-522-1118
- Fax Number
- 212-335-0320
Provider Business Mailing Address Details
- Address
- 94 Bowery
New York, NY 10013-4888 - City
- New York
- State
- NY
- Zip
- 10013-4888
- Phone Number
- 212-335-0328
License Information
- License Number (1)
- 250205
- License State (1)
- NY
- Taxonomy (1)
- Specialist · 174400000X
- License Number (2)
- 228377
- License State (2)
- NY
- Taxonomy (2)
- Specialist · 174400000X
- Taxonomy (3)
- Clinic/Center, Radiology, Mammography · 261QR0206X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Excelsior Integrated Medical Group, PLLC?
The NPI number of Excelsior Integrated Medical Group, PLLC is 1881053775. It was assigned on February 19, 2016 and is currently active in the NPPES registry.
What is the specialty of Excelsior Integrated Medical Group, PLLC?
Excelsior Integrated Medical Group, PLLC is registered under the primary taxonomy Clinic/Center, Radiology, Mammography (code 261QR0206X), licensed in NY under license number 250205.
Where does Excelsior Integrated Medical Group, PLLC practice?
The practice location is 758 61ST St, Brooklyn, NY 11220-4212. The office can be reached at 718-522-1118 (phone) or 212-335-0320 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1881053775 directly on the NPPES registry website.