Provider Demographics
NPI:1912946351
Name:COMPREHENSIVE PAIN MEDICINE P.C.
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRZEGORZ
Authorized Official - Middle Name:PIOTR
Authorized Official - Last Name:KOZIKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-208-3244
Mailing Address - Street 1:14222 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2319
Mailing Address - Country:US
Mailing Address - Phone:718-357-3818
Mailing Address - Fax:
Practice Address - Street 1:146 NORMAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-3311
Practice Address - Country:US
Practice Address - Phone:718-349-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222249207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW2C031Medicare ID - Type Unspecified
NYI00998Medicare UPIN