Provider Demographics
NPI:1982813424
Name:COMPREHENSIVE GYNECOLOGY, PC
Entity type:Organization
Organization Name:COMPREHENSIVE GYNECOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-423-4222
Mailing Address - Street 1:770 JAMES ST STE 100B
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2642
Mailing Address - Country:US
Mailing Address - Phone:315-423-4222
Mailing Address - Fax:315-423-0305
Practice Address - Street 1:770 JAMES ST STE 100B
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2642
Practice Address - Country:US
Practice Address - Phone:315-423-4222
Practice Address - Fax:315-423-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161388207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY54241AMedicare ID - Type Unspecified