Provider Demographics
NPI:1326138298
Name:COMPREHENSIVE PROFESSIONAL SYSTEMS INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE PROFESSIONAL SYSTEMS INC.
Other - Org Name:CPS OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-675-5745
Mailing Address - Street 1:11 HANOVER SQ
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2818
Mailing Address - Country:US
Mailing Address - Phone:212-675-5745
Mailing Address - Fax:212-675-1147
Practice Address - Street 1:11 HANOVER SQ
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2818
Practice Address - Country:US
Practice Address - Phone:212-675-5745
Practice Address - Fax:212-675-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02770661Medicaid