Provider Demographics
NPI:1033425905
Name:COMPLETE MEDICAL PERSONNEL
Entity Type:Organization
Organization Name:COMPLETE MEDICAL PERSONNEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-686-6133
Mailing Address - Street 1:159 S 11TH AVE
Mailing Address - Street 2:SUITE 2S
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2928
Mailing Address - Country:US
Mailing Address - Phone:917-686-6133
Mailing Address - Fax:
Practice Address - Street 1:159 S 11TH AVE
Practice Address - Street 2:SUITE 2S
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2928
Practice Address - Country:US
Practice Address - Phone:917-686-6133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-29
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health