| Comprehensive Professional Medical Pllc | |
|
52 E Route 59 Nanuet NY 10954-2903 | |
| (469) 559-9768 | |
| Not Available |
| Full Name | Comprehensive Professional Medical Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 52 E Route 59, Nanuet, New York |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 4695599768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Professional Medical Pllc 4 Legends Cir Melville NY 11747-5302 Ph: (469) 559-9768 | Comprehensive Professional Medical Pllc 52 E Route 59 Nanuet NY 10954-2903 Ph: (469) 559-9768 |
| NPI Number | 1174389225 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 10/10/2024 |
| Medicare PECOS PAC ID | 3971945395 |
|---|---|
| Medicare Enrollment ID | O20240530000893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174389225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Laura Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568061570 PECOS PAC ID: 2961869953 Enrollment ID: I20230607000358 |
| Provider Name | Jodhvir S Mangat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679064000 PECOS PAC ID: 8123365624 Enrollment ID: I20240530001286 |
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