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General NPI Number Information
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NPI Number | 1992901904
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE DYNAMIC DESIGNS, INC.
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 420 E 82ND ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10028-5901
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Country | US
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Telephone | 212-396-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 420 E 82ND ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10028-5901
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Country | US
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Telephone | 212-396-3901
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW TSE
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Credential | C.O.
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Telephone | 212-396-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CO2850
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License Number State | NY
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