Healthcare Provider Details

I. General information

NPI: 1376686568
Provider Name (Legal Business Name): COMPREHENSIVE HEALTHCARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 16TH AVE
NEWARK NJ
07103-1104
US

IV. Provider business mailing address

297 16TH AVE
NEWARK NJ
07103-1104
US

V. Phone/Fax

Practice location:
  • Phone: 973-374-3020
  • Fax: 973-374-3120
Mailing address:
  • Phone: 973-374-3020
  • Fax: 973-374-3120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. STEVEN A. CHOMSKY
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 973-374-3020