Provider Demographics
NPI:1659056158
Name:PROMPT MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:PROMPT MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-431-0828
Mailing Address - Street 1:1501 VOORHIES AVE APT 22C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4085
Mailing Address - Country:US
Mailing Address - Phone:646-431-0828
Mailing Address - Fax:
Practice Address - Street 1:2083 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3901
Practice Address - Country:US
Practice Address - Phone:718-975-2035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies