Organization
PROGRESSIVE O & P, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL H BASTIAN CP (VICE PRESIDENT)
(516) 338-8585
Entity
Organization
Contact information
Practice address
1111 WILLIS AVENUE, ALBERTSON, NY 11507-1230
(516) 338-8585
(516) 338-7575
Mailing address
1111 WILLIS AVENUE, ALBERTSON, NY 11507-1230
(516) 338-8585
(516) 338-7575
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02072719
—
NY
01
—
2225560
AETNA
NY
01
—
A2005136
OXFORD
NY
Enumeration date
01/30/2006
Last updated
09/08/2011
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