| Comprehensive Behavioral Medical Care Pc | |
|
750 Fulton St Farmingdale NY 11735-3642 | |
| (631) 249-2765 | |
| (631) 249-3617 |
| Full Name | Comprehensive Behavioral Medical Care Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 750 Fulton St, Farmingdale, New York |
| Authorized Official Name and Position | Martin A Chrisphonte (SECRETARY) |
| Authorized Official Contact | 6312492765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Behavioral Medical Care Pc 750 Fulton St Farmingdale NY 11735-3642 Ph: (631) 249-2765 | Comprehensive Behavioral Medical Care Pc 750 Fulton St Farmingdale NY 11735-3642 Ph: (631) 249-2765 |
| NPI Number | 1558357442 |
|---|---|
| Provider Enumeration Date | 09/26/2005 |
| Last Update Date | 04/08/2008 |
| Medicare PECOS PAC ID | 0941253785 |
|---|---|
| Medicare Enrollment ID | O20050222000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558357442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jeanine C Cantave |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588658553 PECOS PAC ID: 2264485002 Enrollment ID: I20050228000172 |
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