Provider Demographics
NPI:1861720435
Name:INTEGRATED HEALTH ADMINISTRATIVE SERVICES, INC.
Entity type:Organization
Organization Name:INTEGRATED HEALTH ADMINISTRATIVE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:TANZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-438-7600
Mailing Address - Street 1:141 HALSTEAD AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2607
Mailing Address - Country:US
Mailing Address - Phone:914-777-8300
Mailing Address - Fax:914-777-8304
Practice Address - Street 1:141 HALSTEAD AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2607
Practice Address - Country:US
Practice Address - Phone:914-777-8300
Practice Address - Fax:914-777-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG300000019Medicare UPIN