Healthcare Provider Details

I. General information

NPI: 1437061082
Provider Name (Legal Business Name): PROMEDI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 W FAIRVIEW AVE
VALLEY STREAM NY
11580-5763
US

IV. Provider business mailing address

85 W FAIRVIEW AVE
VALLEY STREAM NY
11580-5763
US

V. Phone/Fax

Practice location:
  • Phone: 346-396-1252
  • Fax:
Mailing address:
  • Phone: 346-396-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAKEEL AHMAD
Title or Position: OWNER
Credential:
Phone: 346-396-1252