Provider Demographics
NPI:1366688921
Name:COMPREHENSIVE ACUPUNCTURE PLLC.
Entity Type:Organization
Organization Name:COMPREHENSIVE ACUPUNCTURE PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGDUL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-749-2171
Mailing Address - Street 1:150-67 VILLAGE RD APT 57B
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:718-749-2171
Mailing Address - Fax:718-261-7886
Practice Address - Street 1:108-14 72 AV 4TH FLOOR
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-749-2171
Practice Address - Fax:718-261-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002366261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY173605OtherELDERPLAN