Provider Demographics
NPI:1235456864
Name:COMPREHENSIVE HEALTHCARE MEDICAL PC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTHCARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMUR
Authorized Official - Middle Name:
Authorized Official - Last Name:HANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-538-7217
Mailing Address - Street 1:6730 CLYDE ST APT 7H
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6730 CLYDE ST APT 7H
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4006
Practice Address - Country:US
Practice Address - Phone:917-538-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2380025174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty