MEDICARE: PROMED PREFERRED CO 2, 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1730061961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMED PREFERRED CO 2, PLLC

Provider Business Mailing Address
First Line	:	329 S OYSTER BAY RD # 2059
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-3301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1560 BROADWAY UNIT 1791
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-6000
Country	:	US
Telephone Number	:	615-499-3165
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEV GRINMAN
Credential	:	MD
Telephone Number	:	615-499-3165

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/24/2025

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