Provider Demographics
NPI:1346557964
Name:NEW YORK COMPREHENSIVE MEDICAL PC
Entity Type:Organization
Organization Name:NEW YORK COMPREHENSIVE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-417-9094
Mailing Address - Street 1:PO BOX 740017
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11374-0017
Mailing Address - Country:US
Mailing Address - Phone:347-417-9094
Mailing Address - Fax:718-732-2434
Practice Address - Street 1:23-25 31ST STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105
Practice Address - Country:US
Practice Address - Phone:347-417-9094
Practice Address - Fax:718-732-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty