NPIMap

Organization Active NPI

Integrative Neurology, P.C.

  • Specialist
  • Port Jefferson Station, NY
National Provider Identifier
1366734014
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
222694 Issued in NY
Legal business name
INTEGRATIVE NEUROLOGY, P.C.
Practice address
1174 Route 112
Port Jefferson Station, NY 11776-8003
Phone
(631) 509-1730
Fax
(631) 509-1728
NPI assigned
May 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Frank Wohlsein Telang, M.D.
Title
President
Phone
(631) 509-1730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 222694 NY Primary

Addresses

Primary practice location

1174 Route 112
Port Jefferson Station, NY 11776-8003

Mailing address

1174 Route 112
Port Jefferson Station, NY 11776-8033
Phone (631) 509-1730

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1366734014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768033",
            "telephone_number": "631-509-1730",
            "fax_number": "631-509-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768003",
            "telephone_number": "631-509-1730",
            "fax_number": "631-509-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE NEUROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "TELANG",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "WOHLSEIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-509-1730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "222694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.