Provider Demographics
NPI:1275868150
Name:COMPREHENSIVE BLOOD &CANCER MEDICAL CARE,PC
Entity Type:Organization
Organization Name:COMPREHENSIVE BLOOD &CANCER MEDICAL CARE,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAUZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARACHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-562-6240
Mailing Address - Street 1:5109 ROUTE 9W
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1952
Mailing Address - Country:US
Mailing Address - Phone:845-562-6240
Mailing Address - Fax:845-562-6246
Practice Address - Street 1:5109 ROUTE 9W
Practice Address - Street 2:SUITE 2
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1952
Practice Address - Country:US
Practice Address - Phone:845-562-6240
Practice Address - Fax:845-562-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200338207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01726489Medicaid
G43532Medicare UPIN