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

Excelsior Integrated Medical Group, PLLC

Organization Specialist · NPI 1689009854

Excelsior Integrated Medical Group, PLLC is a Specialist in New York, New York. Licensed in New York. Registered with an NPI since 2013.

Licensed in
NY
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

217 Grand St Ste 401
New York, NY 10013-4396
Phone: (212) 390-1830
Fax: (212) 390-8177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 203601 (NY)

Record details

NPI number1689009854
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official George Hall — President · (212) 335-0328
NPI enumeratedSeptember 6, 2013
Last updated in NPPESFebruary 3, 2016
Mailing address217 Grand St, Suite 401, New York, NY 10013-4396

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