Provider Demographics
NPI:1396981882
Name:COMPREHENSIVE MULTI-SPECIALTY MEDICAL GROUP, PC
Entity type:Organization
Organization Name:COMPREHENSIVE MULTI-SPECIALTY MEDICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-320-5227
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-0255
Mailing Address - Country:US
Mailing Address - Phone:201-342-0444
Mailing Address - Fax:201-342-0709
Practice Address - Street 1:556 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1503
Practice Address - Country:US
Practice Address - Phone:201-342-0444
Practice Address - Fax:201-342-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08501200208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty