| Progressive Medical Fitness Pc | |
|
389 Fort Salonga Rd Ste 2 Northport NY 11768-3089 | |
| (631) 201-2474 | |
| (631) 382-8325 |
| Full Name | Progressive Medical Fitness Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 389 Fort Salonga Rd Ste 2, Northport, New York |
| Authorized Official Name and Position | Harold Avella (OWNER) |
| Authorized Official Contact | 6312012474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Fitness Pc 389 Fort Salonga Rd Ste 2 Northport NY 11768-3089 Ph: (631) 201-2474 | Progressive Medical Fitness Pc 389 Fort Salonga Rd Ste 2 Northport NY 11768-3089 Ph: (631) 201-2474 |
| NPI Number | 1720608151 |
|---|---|
| Provider Enumeration Date | 04/27/2020 |
| Last Update Date | 04/27/2020 |
| Medicare PECOS PAC ID | 3476974486 |
|---|---|
| Medicare Enrollment ID | O20200529001711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720608151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
| Provider Name | Harold Avella |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1770502965 PECOS PAC ID: 6103861174 Enrollment ID: I20050621001101 |
| Provider Name | Behrouz Farahmandpour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447246756 PECOS PAC ID: 4981634516 Enrollment ID: I20050815000132 |
| Provider Name | Yevgeniya Schrettner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336682095 PECOS PAC ID: 8123309697 Enrollment ID: I20161222000212 |
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