Basic Information
Provider Information
NPI: 1740956606
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POST
FirstName: MICHAEL
MiddleName: JOHN
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PROGRESSIVE EMERGENCY PHYSICIANS
Address2: 1236 RXR PLAZA
City: UNIONDALE
State: NY
PostalCode: 11556
CountryCode: US
TelephoneNumber: 5162523939
FaxNumber:  
Practice Location
Address1: LONG ISLAND COMMUNITY HOSPITAL
Address2: 101 HOSPITAL ROAD
City: PATCHOGUE
State: NY
PostalCode: 11772
CountryCode: US
TelephoneNumber: 6316547100
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/20/2021
LastUpdateDate: 08/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X026918NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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