1407938822 NPI number — COMPREHENSIVE HEADACHE AND PAIN SOLUTIONS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407938822 NPI number — COMPREHENSIVE HEADACHE AND PAIN SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE HEADACHE AND PAIN SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407938822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4211 LIGHTHOUSE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST CHESTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-282-3668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10945 REED HARTMAN HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE # 219 217
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-891-3600
Provider Business Practice Location Address Fax Number:
513-891-3601
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
USMANI
Authorized Official First Name:
JAVARIA
Authorized Official Middle Name:
AHSAN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
718-619-7461

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X , with the licence number:  87875 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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