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 provides Specialist services 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 Not confirmed with CMS for 10 years — call before visiting
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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