Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Excelsior Integrated Medical Group

Organization Adult Health Nurse Practitioner · NPI 1275081838

Excelsior Integrated Medical Group is an Adult Health Nurse Practitioner in New York, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016

Practice location Address checks out

217 Grand St Ste 401
New York, NY 10013-4396
Phone: (212) 390-1830
Fax: (212) 390-8177
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 9389049 (NY)

Record details

NPI number1275081838
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Geogre Hall — President · (718) 938-3188
NPI enumeratedSeptember 13, 2016
Last updated in NPPESSeptember 13, 2016
Mailing address217 Grand St, Suite 401, New York, NY 10013-4396

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