Provider Demographics
NPI:1376821355
Name:WHEELS OF PROGRESS
Entity Type:Organization
Organization Name:WHEELS OF PROGRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-645-3265
Mailing Address - Street 1:64 E 111TH ST
Mailing Address - Street 2:SUITE 907
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0249
Mailing Address - Country:US
Mailing Address - Phone:347-645-3265
Mailing Address - Fax:
Practice Address - Street 1:64 E 111TH ST
Practice Address - Street 2:SUITE 907
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-0249
Practice Address - Country:US
Practice Address - Phone:347-645-3265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03489278Medicaid
NY1100046805OtherSFS VENDOR ID