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General NPI Number Information
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NPI Number | 1376044057
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Entity Type | Organization
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Legal Business Name | COMPERHENSIVE CHILD CARE PEDIATRICS P.C.
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 458 BAY RIDGE PKWY
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City | BROOKLYN
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State | NY
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Zip | 11209-2702
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Country | US
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Telephone | 718-833-0741
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Fax | 877-991-6654
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Provider Business Mailing Address
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Address Line | 322 88TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-5602
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Country | US
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Telephone | 347-968-5637
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. AHMAD K MAHDI
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Credential | MD
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Telephone | 347-951-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 274922
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License Number State | NY
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