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NPI Code Detail

MEDICARE: PREVENTIVE HEALTH MEDICAL NY, PLLC

MEDICARE: PREVENTIVE HEALTH MEDICAL NY, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1073461521
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREVENTIVE HEALTH MEDICAL NY, PLLC
Provider Business Mailing Address
First Line : 240 W 37TH ST FL 5
Second Line : 515W
City : NEW YORK
State : NY
Zip : 10018-5787
Country : US
Telephone Number : 410-935-4608
Fax Number :
Provider Business Practice Location Address
First Line : 240 W 37TH ST FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10018-5787
Country : US
Telephone Number : 410-935-4608
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. JEFFREY VOGEL
Credential : MD
Telephone Number : 410-935-4608
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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