| Progressive Neurology Llc | |
|
2405 Whittier Dr Unit 100 Frederick MD 21702-3361 | |
| (301) 682-2988 | |
| Not Available |
| Full Name | Progressive Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2405 Whittier Dr Unit 100, Frederick, Maryland |
| Authorized Official Name and Position | Raya Massoud (DIRECTOR) |
| Authorized Official Contact | 3017997588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Neurology Llc 2405 Whittier Dr Unit 100 Frederick MD 21702-3361 Ph: (301) 799-7588 | Progressive Neurology Llc 2405 Whittier Dr Unit 100 Frederick MD 21702-3361 Ph: (301) 682-2988 |
| NPI Number | 1235777210 |
|---|---|
| Provider Enumeration Date | 12/20/2019 |
| Last Update Date | 01/01/2020 |
| Certification Date | 01/01/2020 |
| Medicare PECOS PAC ID | 6901232321 |
|---|---|
| Medicare Enrollment ID | O20200204000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235777210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Raya Massoud |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831370063 PECOS PAC ID: 1052616422 Enrollment ID: I20160223000766 |
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