Provider Demographics
NPI:1134369481
Name:PROGRESSIVE GASTROENTEROLOGY LLC
Entity type:Organization
Organization Name:PROGRESSIVE GASTROENTEROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-231-4443
Mailing Address - Street 1:3584 JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1006
Mailing Address - Country:US
Mailing Address - Phone:718-231-4443
Mailing Address - Fax:718-708-4821
Practice Address - Street 1:3584 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1006
Practice Address - Country:US
Practice Address - Phone:718-231-4440
Practice Address - Fax:718-708-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207ZP0101X
NY175708207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty