Provider Demographics
NPI:1467785410
Name:COMPREHENSIVE ENDOSCOPY OF LI
Entity Type:Organization
Organization Name:COMPREHENSIVE ENDOSCOPY OF LI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-640-5884
Mailing Address - Street 1:146A MANETTO HILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1323
Mailing Address - Country:US
Mailing Address - Phone:516-640-5882
Mailing Address - Fax:516-640-5882
Practice Address - Street 1:146A MANETTO HILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1323
Practice Address - Country:US
Practice Address - Phone:516-640-5882
Practice Address - Fax:516-640-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy