Provider Demographics
NPI:1427018100
Name:COMPREHENSIVE MEDICAL NETWORK PC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL NETWORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PARANICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-451-1122
Mailing Address - Street 1:102 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518
Mailing Address - Country:US
Mailing Address - Phone:570-451-1122
Mailing Address - Fax:570-451-0544
Practice Address - Street 1:102 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518
Practice Address - Country:US
Practice Address - Phone:570-451-1122
Practice Address - Fax:570-451-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA722839OtherBCBS
PA722839Medicare ID - Type Unspecified