MEDICARE: COMPREHENSIVE PSYCHIATRIC EVALUATION 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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1871644559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE PSYCHIATRIC EVALUATION PC

Provider Business Mailing Address
First Line	:	3411 GUIDER AVE
Second Line	:	6 FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5235
Country	:	US
Telephone Number	:	718-614-6167
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 OCEAN PKWY
Second Line	:	SUITE 1U
City	:	BROOKLYN
State	:	NY
Zip	:	11218-2567
Country	:	US
Telephone Number	:	718-614-6167
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZINAIDA LYUBOFF
Credential	:	MD
Telephone Number	:	718-614-6167

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	11/01/2007

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