Provider Demographics
NPI:1972973154
Name:COMPREHENSIVE PRIMARY CARE SERVICES PC
Entity Type:Organization
Organization Name:COMPREHENSIVE PRIMARY CARE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:IJEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKA-NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-235-7530
Mailing Address - Street 1:1040 E 227TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4818
Mailing Address - Country:US
Mailing Address - Phone:718-547-1541
Mailing Address - Fax:
Practice Address - Street 1:175 MEMORIAL HWY
Practice Address - Street 2:SUITE 2-1
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5635
Practice Address - Country:US
Practice Address - Phone:914-235-7530
Practice Address - Fax:914-235-8470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3831174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty