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General NPI Number Information
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NPI Number | 1568889277
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Entity Type | Organization
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Legal Business Name | COMSTI MEDICAL, LLC
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 444 NEPTUNE BLVD BUILDING B, SUITE 2
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City | NEPTUNE
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State | NJ
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Zip | 07753-4144
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Country | US
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Telephone | 732-774-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 444 NEPTUNE BLVD BUILDING B, SUITE 2
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City | NEPTUNE
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State | NJ
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Zip | 07753-4144
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Country | US
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Telephone | 732-774-0436
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. MARIA VIRGINIA COMSTI
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Credential | M.D.
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Telephone | 732-890-4895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA06813500
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License Number State | NJ
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