Provider Demographics
NPI:1598193880
Name:COMPREHENSIVE MEDICAL MULTI-SPECIALTY PC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL MULTI-SPECIALTY PC
Other - Org Name:CMMS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIFTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-804-6155
Mailing Address - Street 1:200 EAST 36 STREET
Mailing Address - Street 2:11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:877-372-3266
Mailing Address - Fax:877-372-3266
Practice Address - Street 1:200 EAST 36 STREET
Practice Address - Street 2:11C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:877-372-3266
Practice Address - Fax:877-372-3266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219733261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty