Provider Demographics
NPI:1588975668
Name:COMPREHENSIVE MEDICAL HEALTH WELLNESS, PC
Entity type:Organization
Organization Name:COMPREHENSIVE MEDICAL HEALTH WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:KHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-609-9400
Mailing Address - Street 1:3 DOSORIS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1539
Mailing Address - Country:US
Mailing Address - Phone:516-609-9400
Mailing Address - Fax:
Practice Address - Street 1:3 DOSORIS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1539
Practice Address - Country:US
Practice Address - Phone:516-609-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228173261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation