Provider Demographics
NPI:1649767013
Name:COMPLETE EXPRESS MEDICAL PC
Entity Type:Organization
Organization Name:COMPLETE EXPRESS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-318-3062
Mailing Address - Street 1:3047 AVENUE U STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5144
Mailing Address - Country:US
Mailing Address - Phone:347-702-4066
Mailing Address - Fax:347-702-4065
Practice Address - Street 1:3047 AVENUE U STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5144
Practice Address - Country:US
Practice Address - Phone:347-702-4066
Practice Address - Fax:347-702-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty