Provider Demographics
NPI:1710113618
Name:COMPREHENSIVE PEDIATRICS, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-871-5100
Mailing Address - Street 1:18099 LORAIN RD
Mailing Address - Street 2:#304
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111
Mailing Address - Country:US
Mailing Address - Phone:216-476-2300
Mailing Address - Fax:216-476-9234
Practice Address - Street 1:18099 LORAIN RD
Practice Address - Street 2:#304
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111
Practice Address - Country:US
Practice Address - Phone:216-476-2300
Practice Address - Fax:216-476-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty