MEDICARE: ARTHUR AVENUE COMPREHENSIVE HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	284300000X	Special Hospital	183971	NY

General Provider Information

NPI Number	:	1821131608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHUR AVENUE COMPREHENSIVE HEALTH

Provider Business Mailing Address
First Line	:	2385 ARTHUR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-8184
Country	:	US
Telephone Number	:	718-562-2481
Fax Number	:	718-562-2482

Provider Business Practice Location Address
First Line	:	2385 ARTHUR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-8184
Country	:	US
Telephone Number	:	718-562-2481
Fax Number	:	718-562-2482

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. BHAGWANTI PERSAUD
Credential	:	MD
Telephone Number	:	718-562-2481

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/06/2008

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