Provider Demographics
NPI:1659679538
Name:COMPREHENSIVE MEDICAL CARE OF ROCKLAND COUNTY PC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL CARE OF ROCKLAND COUNTY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-2005
Mailing Address - Street 1:337 N MAIN ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4310
Mailing Address - Country:US
Mailing Address - Phone:845-634-2005
Mailing Address - Fax:845-638-6665
Practice Address - Street 1:337 N MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4310
Practice Address - Country:US
Practice Address - Phone:845-634-2005
Practice Address - Fax:845-638-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188292-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty