Healthcare Provider Details

I. General information

NPI: 1942273032
Provider Name (Legal Business Name): COMPREHENSIVE MEDICAL ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 RT 9 STE 6 COMPREHENSIVE MEDICAL
LANOKA HARBOR NJ
08734
US

IV. Provider business mailing address

PO BOX 340
MANAHAWKIN NJ
08005
US

V. Phone/Fax

Practice location:
  • Phone: 609-971-1711
  • Fax: 609-971-3390
Mailing address:
  • Phone: 609-971-1711
  • Fax: 609-971-3390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA TAURO
Title or Position: OFFICE MANAGER
Credential:
Phone: 609-971-1711