Integrative 1 Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

259884 Issued in NY

Legal business name

INTEGRATIVE 1 MEDICAL PC

Practice address

2060 Bellmore Ave
Bellmore, NY 11710-5604

Phone

(516) 755-5855

Fax

(516) 755-0330

NPI assigned

Apr 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Heskell Khozouri-Zadeh, DC

Title

Manager

Phone

(516) 755-5855

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1891051918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105604",
            "telephone_number": "516-755-5855",
            "fax_number": "516-755-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105604",
            "telephone_number": "516-755-5855",
            "fax_number": "516-755-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE 1 MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "KHOZOURI-ZADEH",
        "authorized_official_first_name": "HESKELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-755-5855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "010621",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "244460",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "259884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra L Iannarelli
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• General Practice Physician in Bellmore, NY
• Providers in Bellmore, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.