Provider Demographics
NPI:1144383258
Name:COMPREHENSIVE PSYCHIATRIC SERVICES, P.C.
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-743-0771
Mailing Address - Street 1:135 OCEANA DR E APT PH2B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6698
Mailing Address - Country:US
Mailing Address - Phone:718-743-0771
Mailing Address - Fax:
Practice Address - Street 1:2269 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3103
Practice Address - Country:US
Practice Address - Phone:718-339-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201591174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW33931Medicare PIN
NY06222Medicare PIN