Healthcare Provider Details

I. General information

NPI: 1427018100
Provider Name (Legal Business Name): COMPREHENSIVE MEDICAL NETWORK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N MAIN ST
OLD FORGE PA
18518
US

IV. Provider business mailing address

102 N MAIN ST
OLD FORGE PA
18518
US

V. Phone/Fax

Practice location:
  • Phone: 570-451-1122
  • Fax: 570-451-0544
Mailing address:
  • Phone: 570-451-1122
  • Fax: 570-451-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier722839
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBCBS

VIII. Authorized Official

Name: STEPHEN ROBERT PARANICH
Title or Position: PRESIDENT
Credential: DC
Phone: 570-451-1122