| Promed Preferred NH, PC | |
|
11 Dartmouth Rd Highland Mills NY 10930-2604 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed Preferred NH, PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 11 Dartmouth Rd, Highland Mills, New York |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred NH, PC 329 S Oyster Bay Rd # 2059 Plainview NY 11803-3301 | Promed Preferred NH, PC 11 Dartmouth Rd Highland Mills NY 10930-2604 Ph: (615) 499-3165 |
| NPI Number | 1336039429 |
|---|---|
| Provider Enumeration Date | 07/08/2025 |
| Last Update Date | 07/08/2025 |
| Certification Date | 07/08/2025 |
| Medicare PECOS PAC ID | 1557862448 |
|---|---|
| Medicare Enrollment ID | O20250902001160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336039429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Michelle D Momenee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407135569 PECOS PAC ID: 1254502149 Enrollment ID: I20110926000842 |
| Provider Name | Nadege Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760732127 PECOS PAC ID: 0042459026 Enrollment ID: I20221123002108 |
Provider Medical Services Ny, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 49 Milval Ln, Highland Mills, NY 10930 Phone: 615-499-3165 |