Provider Demographics
NPI:1083717672
Name:COMPREHENSIVE OB & GYN MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:COMPREHENSIVE OB & GYN MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:CHAPARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-651-2300
Mailing Address - Street 1:41-07 76TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1929
Mailing Address - Country:US
Mailing Address - Phone:718-651-2300
Mailing Address - Fax:718-651-3638
Practice Address - Street 1:4107 76TH ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1929
Practice Address - Country:US
Practice Address - Phone:718-651-2300
Practice Address - Fax:718-651-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109835207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100000007Medicare PIN