Organization
PROFESSIONAL EVALUATION MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MICHAEL SHEEHY (EXECUTIVE DIRECTOR)
(516) 935-4378
Entity
Organization
Contact information
Practice address
380 S BROADWAY, HICKSVILLE, NY 11801-5033
(516) 935-4378
(516) 931-3117
Mailing address
380 S BROADWAY, HICKSVILLE, NY 11801-5033
(516) 935-4378
(516) 931-3117
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
147150
NY
Other
Enumeration date
02/16/2007
Last updated
11/10/2011
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