Healthcare Provider Details

I. General information

NPI: 1275868150
Provider Name (Legal Business Name): COMPREHENSIVE BLOOD &CANCER MEDICAL CARE,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5109 ROUTE 9W SUITE 2
NEWBURGH NY
12550-1952
US

IV. Provider business mailing address

5109 ROUTE 9W SUITE 2
NEWBURGH NY
12550-1952
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-6240
  • Fax: 845-562-6246
Mailing address:
  • Phone: 845-562-6240
  • Fax: 845-562-6246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number200338
License Number StateNY

VIII. Authorized Official

Name: FAUZIA PARACHA
Title or Position: OWNER
Credential: M.D.
Phone: 845-562-6240