Integrated Medical Health Care PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

206669 Issued in NY

Legal business name

INTEGRATED MEDICAL HEALTH CARE PC

Practice address

624 Townline Rd
Hauppauge, NY 11788-2821

Phone

(631) 366-3334

Fax

(631) 366-3233

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Harvey Wieder, M.D.

Title

President

Phone

(631) 366-3334

Specialties & licenses 1

Addresses

Other identifiers 9

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750430609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 TOWNLINE RD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882821",
            "telephone_number": "631-366-3334",
            "fax_number": "631-366-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 TOWNLINE RD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882821",
            "telephone_number": "631-366-3334",
            "fax_number": "631-366-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL HEALTH CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIEDER",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-366-3334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "206669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01797382",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "6138162-007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA70462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2370468",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "OD2081",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "477164",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2007635",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI - GROUP HEALTH INC",
            "identifier": "5904677",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT PRO",
            "identifier": "SF-0002620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.