Healthcare Provider Details

I. General information

NPI: 1205769486
Provider Name (Legal Business Name): PEACEFUL PROGRESS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 PRESCOTT AVE
STATEN ISLAND NY
10306-3246
US

IV. Provider business mailing address

279 PRESCOTT AVE
STATEN ISLAND NY
10306-3246
US

V. Phone/Fax

Practice location:
  • Phone: 917-496-6547
  • Fax: 888-649-3690
Mailing address:
  • Phone: 917-496-6547
  • Fax: 888-649-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LILLIAN MCNAMARA
Title or Position: PRESIDENT
Credential: NP
Phone: 917-496-6547