Healthcare Provider Details

I. General information

NPI: 1669548087
Provider Name (Legal Business Name): ADVANCED INTERNAL MEDICINE GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NORTHERN BLVD SUITE 133
GREENVALE NY
11548-1219
US

IV. Provider business mailing address

2200 NORTHERN BLVD STE 133
GREENVALE NY
11548-1226
US

V. Phone/Fax

Practice location:
  • Phone: 516-352-8100
  • Fax: 516-352-7348
Mailing address:
  • Phone: 516-352-8100
  • Fax: 516-352-7348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number138681
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEON SCHWECHTER
Title or Position: PRESIDENT
Credential: DO
Phone: 516-352-8100