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General NPI Number Information
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NPI Number | 1396981882
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MULTI-SPECIALTY MEDICAL GROUP, PC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 556 EAGLE ROCK AVE SUITE 208
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City | ROSELAND
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State | NJ
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Zip | 07068-1503
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Country | US
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Telephone | 201-342-0444
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Fax | 201-342-0709
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Provider Business Mailing Address
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Address Line | PO BOX 1255
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-0255
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Country | US
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Telephone | 201-342-0444
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Fax | 201-342-0709
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY MARSH
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Credential | D.O.
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Telephone | 201-320-5227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MB08501200
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License Number State | NJ
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