Provider Demographics
NPI:1750926390
Name:COMPREHENSIVE FAMILY MEDICAL LLC
Entity type:Organization
Organization Name:COMPREHENSIVE FAMILY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSELNIKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-589-1421
Mailing Address - Street 1:15 DIAMOND BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3170
Mailing Address - Country:US
Mailing Address - Phone:732-414-6506
Mailing Address - Fax:
Practice Address - Street 1:100 CRAIG RD STE 110
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8731
Practice Address - Country:US
Practice Address - Phone:732-414-6506
Practice Address - Fax:732-414-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty