Organization
PROGRESSIVE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENDEL D MCKENNA MHA (ADMINISTRATOR)
(631) 694-0000
Entity
Organization
Contact information
Practice address
340 BROADHOLLOW RD, FARMINGDALE, NY 11735-4807
(631) 694-0000
(631) 694-2470
Mailing address
340 BROADHOLLOW RD, FARMINGDALE, NY 11735-4807
(631) 694-0000
(631) 694-2470
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
5150202R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02490288
—
NY
Enumeration date
09/28/2006
Last updated
05/07/2012
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