Provider Demographics
NPI:1982736047
Name:COMPREHENSIVE WOMEN'S HEALTH OF N.Y. PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE WOMEN'S HEALTH OF N.Y. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETR
Authorized Official - Middle Name:
Authorized Official - Last Name:ITZHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-366-2242
Mailing Address - Street 1:8344 LEFFERTS BLVD APT 4R
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2583
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6805 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7267
Practice Address - Country:US
Practice Address - Phone:718-366-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234430207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty