Healthcare Provider Details

I. General information

NPI: 1780908863
Provider Name (Legal Business Name): AMERICAN COMPREHENSIVE HEALTHCARE MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205-7 CHURCH AVE
BROOKLYN NY
11203-3513
US

IV. Provider business mailing address

5205-7 CHURCH AVE
BROOKLYN NY
11203-3513
US

V. Phone/Fax

Practice location:
  • Phone: 718-688-8000
  • Fax: 718-688-8081
Mailing address:
  • Phone: 718-688-8088
  • Fax: 718-688-8081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KAREN HENRY
Title or Position: COO
Credential:
Phone: 718-688-8000