| Comprehensive Ny Professional Medical Pllc | |
|
7256 Route 209 Wawarsing NY 12489-2016 | |
| (845) 728-8872 | |
| Not Available |
| Full Name | Comprehensive Ny Professional Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7256 Route 209, Wawarsing, New York |
| Authorized Official Name and Position | Lev Grinman (CO-OWNER) |
| Authorized Official Contact | 6466731660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Ny Professional Medical Pllc 4 Legends Cir Melville NY 11747-5302 Ph: (646) 673-1666 | Comprehensive Ny Professional Medical Pllc 7256 Route 209 Wawarsing NY 12489-2016 Ph: (845) 728-8872 |
| NPI Number | 1750157111 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 03/05/2024 |
| Medicare PECOS PAC ID | 1153769708 |
|---|---|
| Medicare Enrollment ID | O20240402003121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750157111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shante Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669072344 PECOS PAC ID: 6507254521 Enrollment ID: I20211025002307 |
| Provider Name | Itay Keshet |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053675207 PECOS PAC ID: 1355693771 Enrollment ID: I20220412001745 |
| Provider Name | Fleeta Burgess-okolie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710121942 PECOS PAC ID: 6800065699 Enrollment ID: I20230125000301 |
Vladimir Andries Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7256 Route 209, Wawarsing, NY 12489 Phone: 845-647-5334 Fax: 845-294-4333 |