Provider Demographics
NPI:1598723827
Name:COMSTI, ERIC ABARY (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ABARY
Last Name:COMSTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIC LUKE
Other - Middle Name:ABARY
Other - Last Name:COMSTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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:732-657-8111
Mailing Address - Fax:732-657-7828
Practice Address - Street 1:681 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEHURST
Practice Address - State:NJ
Practice Address - Zip Code:08733-2853
Practice Address - Country:US
Practice Address - Phone:732-657-8111
Practice Address - Fax:732-657-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA064217NJ207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7484305Medicaid
NJ892885QFNMedicare ID - Type Unspecified
NJ7484305Medicaid