Integrated Medical Interventional Diagnostics PC

Primary specialty

Pain Management Registered NurseTaxonomy code 163WP0000X

License

229328

Legal business name

INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC

Practice address

1111 Broad Hollow Rd 110 Suite 114
Farmingdale, NY 11735

Phone

(516) 336-8659

NPI assigned

Apr 20, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Hasib Mikael Sarij, MD

Title

Owner

Phone

(516) 336-8659

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1962856450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BROAD HOLLOW RD 110 SUITE 114",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "11735",
            "telephone_number": "516-336-8659",
            "fax_number": "516-253-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BROAD HOLLOW RD 110 SUITE 114",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "11735",
            "telephone_number": "516-336-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL INTERVENTIONAL DIAGNOSTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "SARIJ",
        "authorized_official_first_name": "HASIB",
        "authorized_official_middle_name": "MIKAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-336-8659",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": "229328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02549791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.