MEDICARE: COMPREHENSIVE MEDICINE OF LONG ISLAND PC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1033205927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE MEDICINE OF LONG ISLAND PC.

Provider Business Mailing Address
First Line	:	PO BOX 802
Second Line	:
City	:	BELLMORE
State	:	NY
Zip	:	11710-0802
Country	:	US
Telephone Number	:	516-783-0256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1836 BELLMORE AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-5554
Country	:	US
Telephone Number	:	516-783-0256
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LARRY PLEENER
Credential	:	M.D.
Telephone Number	:	516-783-0256

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/22/2020

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