Comprehensive Pediatric Care PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA04003700 Issued in NJ

Legal business name

COMPREHENSIVE PEDIATRIC CARE PC

Practice address

119 Prospect St
Ridgewood, NJ 07450-4451

Phone

(201) 445-1212

Fax

(201) 445-9515

NPI assigned

Nov 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Zia Ghavami, M.D.

Title

President

Phone

(201) 445-1212

Specialties & licenses 1

Addresses

Tax ID family

Comprehensive Pediatric Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Comprehensive Pediatric Care

  • Pediatrics Physician
  • New Jersey, NY
  • NPI 1548593692
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1336441336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504451",
            "telephone_number": "201-445-1212",
            "fax_number": "201-445-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504451",
            "telephone_number": "201-445-1212",
            "fax_number": "201-445-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PEDIATRIC CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "GHAVAMI",
        "authorized_official_first_name": "ZIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-445-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04003700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.