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General NPI Number Information
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NPI Number | 1982736047
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE WOMEN'S HEALTH OF N.Y. PLLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6805 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7267
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Country | US
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Telephone | 718-366-2242
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Fax |
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Provider Business Mailing Address
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Address Line | 8344 LEFFERTS BLVD APT 4R
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City | KEW GARDENS
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State | NY
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Zip | 11415-2583
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESEDENT
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Name | PETR ITZHAK
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Credential | D.O.
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Telephone | 717-366-2242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 234430
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License Number State | NY
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