Provider Demographics
NPI:1609897834
Name:COMPREHENSIVE MEDICAL CARE, PC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MERLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-786-5000
Mailing Address - Street 1:14732 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-4042
Mailing Address - Country:US
Mailing Address - Phone:718-786-5000
Mailing Address - Fax:718-349-9458
Practice Address - Street 1:14732 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4042
Practice Address - Country:US
Practice Address - Phone:718-786-5000
Practice Address - Fax:718-349-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00985259Medicaid
04773Medicare ID - Type Unspecified