INTEGRATED TRIBOROUGH MEDICAL, PLLC (NPI# 1154769669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154769669 |
| Entity Type | Organization |
| Organization Name | INTEGRATED TRIBOROUGH MEDICAL, PLLC |
| Practice Address |
1000 Northern Blvd Suite 175 Great Neck NY 11021-5338 |
| Practice Telephone | 6312719151 |
| Practice Fax Number | 6312719155 |
| Mailing Telephone | 6312719151 |
| Mailing Fax Number | 6312719155 |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |
| Authorized Official Name | PERRY STEVENS (OWNER) |
| Authorized Official Telephone | 6312719151 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
179574 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | 179574 | 01 |
| Street Address |
1000 NORTHERN BLVD SUITE 175 |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11021-5338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386649846 | Blanche Fung Liu | Specialist | 1000 Northern Blvd, Ste 140, Great Neck, NY 11021-5312 | 2005-06-20 |
| 1073120739 | Bryan Baracaldo | Physical Therapist | 1000 Northern Blvd, Great Neck, NY 11021-5338 | 2020-09-28 |
| 1013540343 | Peter Magri Jr. | Nurse Practitioner | 1000 Northern Blvd, Great Neck, NY 11021-5338 | 2020-02-14 |
| 1306201066 | Long Island Oral Surgery Associates, PC | Dentist | 1000 Northern Blvd, Suite 180, Great Neck, NY 11021-5338 | 2015-12-23 |
| 1669863072 | Great Neck Orthodontics Pllc | Dentist | 1000 Northern Blvd, Suite 300, Great Neck, NY 11021-5338 | 2015-02-08 |
| 1528491149 | Londa Otti Hackett | Acupuncturist | 1000 Northern Blvd, Suite 150, Great Neck, NY 11021-5338 | 2013-08-19 |
| 1851733752 | Maria Berenato | Audiologist | 1000 Northern Blvd, Suite 330, Great Neck, NY 11021-5338 | 2013-07-22 |
| 1780959866 | Ariel Nassim | Internal Medicine | 1000 Northern Blvd, Ste 375, Great Neck, NY 11021-5312 | 2012-03-21 |
| 1801177076 | H. Sasson, M.d., P.C. | Plastic Surgery | 1000 Northern Blvd, Suite 370, Great Neck, NY 11021 | 2011-09-01 |
| 1053615252 | David Godfried Md PC | Orthopaedic Surgery | 1000 Northern Blvd, Suite 250, Great Neck, NY 11021-5312 | 2011-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097927 | Vital Balance Osteopathy, Pllc | Psychiatry & Neurology | 10 Bond Street, Ste 1, #290, Great Neck, NY 11021 | 2020-09-14 |
| 1770131922 | Bond Orthodontics & Dental Care Pllc | Dentist | 12 Bond Street., Suite#c4, Great Neck, NY 11021 | 2019-08-30 |
| 1295393858 | Ctrip.nyc, Inc. | Emergency Response System Companies | 3 Grace Ave, Suite 106, Great Neck, NY 11021 | 2019-05-30 |
| 1366929267 | Vishva Vajra Acupuncture PC | Acupuncturist | 23a Middle Neck Road, Great Neck, NY 11021 | 2018-07-24 |
| 1518457530 | Assured Quality Home Care, Inc. | In Home Supportive Care | 885 Northern Blvd., Greak Neck, NY 11021 | 2018-05-15 |
| 1881183275 | Liat Mindy Brody | Occupational Therapist | 7 Hickory Dr, Great Neck, NY 11021 | 2018-05-01 |
| 1457853707 | Allison Squillace | Social Worker | 7 Bond Suite 1a, Great Neck, NY 11021 | 2018-03-02 |
| 1275042855 | Seolhee Kang | Acupuncturist | 26 Linden Street, Apt 4c, Great Neck, NY 11021 | 2017-09-26 |
| 1346781598 | Sara Dreiblatt | Speech-Language Pathologist | 211-45 46th Road, Queens, NY 11021 | 2017-03-20 |
| 1962853416 | Darron Yelling Do, PC | Surgery | 305 Northen Blvd, 105, Great Neck, NY 11021 | 2016-06-27 |
| Find all providers in zip 11021 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386823565 | Laurence D. Haber, M.d.,p.c. | Psychiatry & Neurology | 1000 Northern Blvd Ste 110, Great Neck, NY 11021-5312 | 2007-10-24 |
| 1558406777 | Koorosh Dawoodi | Psychiatry & Neurology | 21 South Drive, Great Neck, NY 11021 | 2007-02-21 |
| 1609947795 | Andrew Feigin | Psychiatry & Neurology | Nsuh-dept of Neurology - Movement Disorders Center, 865 Northern Boulevard, Great Neck, NY 11021 | 2006-11-13 |
| 1730259185 | David Eidelberg | Psychiatry & Neurology | Department of Neurology-movement Disorders Center, 865 Northern Boulevard, Great Neck, NY 11021 | 2006-11-09 |
| 1871511238 | Anthony Paul Geraci | Psychiatry & Neurology | 611 Northern Blvd Ste 150, Great Neck, NY 11021-5207 | 2006-07-17 |
| 1780680991 | Abraham M Glasman | Psychiatry & Neurology | 170 Great Neck Rd, Great Neck, NY 11021-3337 | 2005-06-22 |
| 1023493020 | Amanda Persaud | Psychiatry & Neurology | 611 Northern Blvd Ste 150, Great Neck, NY 11021-5207 | 2015-07-21 |
| 1376962696 | Philip Ragone M D P C | Psychiatry & Neurology | 1010 Northern Blvd, Ste 136, Great Neck, NY 11021-5317 | 2014-04-15 |
| 1194160457 | Neeraj Singh | Psychiatry & Neurology | 611 Northern Blvd Ste 150, Great Neck, NY 11021-5207 | 2013-04-30 |
| 1972862803 | Nimalya Ganeshalingam | Psychiatry & Neurology | 170 Great Neck Rd, Great Neck, NY 11021-3357 | 2012-05-12 |
| Find all providers in GREAT NECK | ||||
| City | GREAT NECK |
| Zip Code | 11021 |
Please comment or provide details below to improve the information on INTEGRATED TRIBOROUGH MEDICAL, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.