Provider Demographics
NPI:1881928497
Name:COMPREHENSIVE MEDICAL OFFICE, PC
Entity type:Organization
Organization Name:COMPREHENSIVE MEDICAL OFFICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUNGMAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-746-0900
Mailing Address - Street 1:18901 NORTHERN BLVD # 3F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2824
Mailing Address - Country:US
Mailing Address - Phone:718-746-0900
Mailing Address - Fax:718-746-2390
Practice Address - Street 1:18901 NORTHERN BLVD # 3F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2824
Practice Address - Country:US
Practice Address - Phone:718-746-0900
Practice Address - Fax:718-746-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03030839Medicaid