MEDICARE: LD PROGRESS. INC

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1922780436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LD PROGRESS. INC

Provider Business Mailing Address
First Line	:	2283 E 26TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4941
Country	:	US
Telephone Number	:	917-705-9053
Fax Number	:

Provider Business Practice Location Address
First Line	:	2283 E 26TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4941
Country	:	US
Telephone Number	:	917-705-9053
Fax Number	:

Authorized Official
Title or Position	:	SP.ED
Name	:	LALI DOROSINSKY
Credential	:	MS
Telephone Number	:	917-705-9053

Provider Enumeration Date	:	08/03/2023
Last Update Date	:	08/03/2023

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Directions to “LD PROGRESS. INC ” Practice Location

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