PROGRESSIVE MEDICAL FITNESS PC (NPI# 1720608151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720608151 |
| Entity Type | Organization |
| Organization Name | PROGRESSIVE MEDICAL FITNESS PC |
| Practice Address |
389 Fort Salonga Rd Ste 2 Northport NY 11768-3089 |
| Practice Telephone | 6312012474 |
| Practice Fax Number | 6313828325 |
| Mailing Telephone | 6312012474 |
| Mailing Fax Number | 6313828325 |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | HAROLD AVELLA (OWNER) |
| Authorized Official Telephone | 6312012474 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
389 FORT SALONGA RD STE 2 |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11768-3089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
| 1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
| 1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
| 1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
| 1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
| 1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
| 1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
| 1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
| 1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
| 1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
| Find all providers in zip 11768 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750919635 | Tamara Dudley Mack | Family Medicine | 3802 Biscayne Hills Dr, Northport, AL 35473-2437 | 2020-03-27 |
| 1902438930 | Katharine Anne Womack | Family Medicine | 12 Soundview Dr, Northport, NY 11768-1445 | 2020-02-07 |
| 1316585219 | Cerra Jordan Jackson | Family Medicine | 5710 Watermelon Road, Suite 600, Northport, AL 35473 | 2019-12-11 |
| 1669025144 | Kraydman Medical, P.C. | Family Medicine | 49 Dolphin Ln, Northport, NY 11768-1860 | 2019-07-23 |
| 1164930939 | Brandi Nail Hubbard | Family Medicine | 5004 Al-69, Northport, AL 35473 | 2018-01-16 |
| 1609164334 | Brenainn Mairtin Flanagan | Family Medicine | 12 Burr Ave, Northport, NY 11768-1927 | 2011-07-15 |
| 1144467309 | Caroline J Day | Family Medicine | 5710 Watermelon Road, Suite 600, Northport, AL 35473 | 2009-01-09 |
| 1235310400 | Eray Oge | Family Medicine | 11 Clam Shell Ln, Northport, NY 11768-1140 | 2007-11-16 |
| 1730386749 | Karen J Young | Family Medicine | 220 Bluff Rd, Northport, ME 04849-4206 | 2007-07-02 |
| 1205997285 | Jeffery G Parker M.d. P.C. | Family Medicine | 2810 Lurleen Wallace Boulevard, Northport, AL 35476 | 2006-12-13 |
| Find all providers in NORTHPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.