Provider Demographics
NPI:1376501866
Name:COMSTI, MARIA VIRGINIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VIRGINIA
Last Name:COMSTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 DUNE RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3767
Mailing Address - Country:US
Mailing Address - Phone:732-922-1122
Mailing Address - Fax:732-922-1957
Practice Address - Street 1:3456 W BANGS AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3012
Practice Address - Country:US
Practice Address - Phone:732-922-1122
Practice Address - Fax:732-922-1957
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA068135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7823100Medicaid
020344QFNMedicare ID - Type Unspecified
NJ7823100Medicaid