Provider Demographics
NPI:1508032426
Name:COMPLETE MEDICAL CARE SERVICES OF NEW YORK, PC
Entity type:Organization
Organization Name:COMPLETE MEDICAL CARE SERVICES OF NEW YORK, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSKNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-239-2112
Mailing Address - Street 1:19 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3005
Mailing Address - Country:US
Mailing Address - Phone:212-239-2112
Mailing Address - Fax:212-239-4224
Practice Address - Street 1:19 E 37TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3005
Practice Address - Country:US
Practice Address - Phone:212-239-2112
Practice Address - Fax:212-239-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190271261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain