Provider Demographics
NPI:1851426910
Name:COMFORT MEDICAL PC
Entity Type:Organization
Organization Name:COMFORT MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GODFREY
Authorized Official - Middle Name:U
Authorized Official - Last Name:MBONU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-749-2482
Mailing Address - Street 1:914A COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4040
Mailing Address - Country:US
Mailing Address - Phone:212-749-2482
Mailing Address - Fax:212-749-2484
Practice Address - Street 1:914A COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4040
Practice Address - Country:US
Practice Address - Phone:212-749-2482
Practice Address - Fax:212-749-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2265082084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY419R31Medicare ID - Type UnspecifiedMEDICARE