Provider Demographics
NPI:1205952496
Name:COMPREHENSIVE PAIN MANAGEMENT PC
Entity type:Organization
Organization Name:COMPREHENSIVE PAIN MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:SHUANGWU
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-358-1861
Mailing Address - Street 1:136-36 39TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-888-1151
Mailing Address - Fax:
Practice Address - Street 1:136-36 39 AVE 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-888-1151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
06250Medicare PIN