| Progressive Medical Group Of New York | |
|
575 Broadway Massapequa NY 11758-5019 | |
| (516) 541-1900 | |
| (516) 612-8834 |
| Full Name | Progressive Medical Group Of New York |
|---|---|
| Speciality | Internal Medicine |
| Location | 575 Broadway, Massapequa, New York |
| Authorized Official Name and Position | Chetan Malhotra (PRESIDENT) |
| Authorized Official Contact | 5165411900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Group Of New York 575 Broadway Massapequa NY 11758-5019 Ph: (516) 541-1900 | Progressive Medical Group Of New York 575 Broadway Massapequa NY 11758-5019 Ph: (516) 541-1900 |
| NPI Number | 1568742575 |
|---|---|
| Provider Enumeration Date | 08/22/2011 |
| Last Update Date | 06/08/2014 |
| Medicare PECOS PAC ID | 7214102607 |
|---|---|
| Medicare Enrollment ID | O20111214000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568742575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 220640 (New York) | Primary |
| Provider Name | Chetan Malhotra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821028184 PECOS PAC ID: 5496647331 Enrollment ID: I20040326000207 |
| Provider Name | Sherlin Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770193484 PECOS PAC ID: 5193131894 Enrollment ID: I20210303003178 |
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