Provider Demographics
NPI:1992078406
Name:COMPREHENSIVE MEDICAL CONSULTANT, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE MEDICAL CONSULTANT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:RAGUKONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-986-1003
Mailing Address - Street 1:37 W CENTURY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1409
Mailing Address - Country:US
Mailing Address - Phone:201-986-1003
Mailing Address - Fax:201-986-1680
Practice Address - Street 1:104 E ROUTE 59
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2957
Practice Address - Country:US
Practice Address - Phone:845-507-0783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209466208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty