Provider Demographics
NPI:1699045237
Name:COMFORT WELLNESS MEDICAL PC
Entity Type:Organization
Organization Name:COMFORT WELLNESS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAWAND
Authorized Official - Middle Name:
Authorized Official - Last Name:KHADER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-372-3500
Mailing Address - Street 1:25 BANK ST
Mailing Address - Street 2:APT 214
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-7000
Mailing Address - Country:US
Mailing Address - Phone:212-372-3500
Mailing Address - Fax:
Practice Address - Street 1:25 BANK ST
Practice Address - Street 2:APT 214
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-7000
Practice Address - Country:US
Practice Address - Phone:212-372-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259198207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty