- Practice location
- 300 E Main St Ste 1, Smithtown, NY 11787-2900
- Phone
- 631-656-8796
- Fax
- 631-333-7322
- Last updated
- March 4, 2019
Active Life Health Of Ny PC is a healthcare organization based in Smithtown, NY. Active Life Health Of Ny PC practices in Smithtown, NY. The NPI Number for Active Life Health Of Ny PC is 1275814105 and holds a License No. 2611911 (TX). The current practice location address for Active Life Health Of Ny PC is 300 E Main St Ste 1, Smithtown, NY 11787-2900 and can be reached out via phone at 631-656-8796 and via fax at 631-333-7322.
Provider Profile Details
- NPI Number
- 1275814105
- Provider Name
- Active Life Health Of Ny PC
- Provider Entity Type
- Organization
- Address
- 300 E Main St Ste 1, Smithtown, NY 11787-2900
- Phone Number
- 631-656-8796
- Fax Number
- 631-333-7322
- Primary Taxonomy
- General Practice · 208D00000X
- Organization Subpart
- No
- Authorized Official
- Dr. John J Rush, MD · Owner · 301-928-1697
- Provider Enumeration Date
- September 6, 2011
- Last Update Date
- March 4, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 300 E Main St Ste 1
Smithtown, NY 11787-2900 - City
- Smithtown
- State
- New York
- Zip
- 11787-2900
- Phone Number
- 631-656-8796
- Fax Number
- 631-333-7322
Provider Business Mailing Address Details
- Address
- 363 Route 111
Ste 107-B
Smithtown, NY 11787-4756 - City
- Smithtown
- State
- NY
- Zip
- 11787-4756
- Phone Number
- 631-656-5544
- Fax Number
- 631-656-5545
License Information
- License Number
- 2611911
- License State
- TX
- Taxonomy
- General Practice · 208D00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other General Practice providers near Smithtown, NY
View all General Practice providers in Smithtown →Frequently Asked Questions
What is the NPI number of Active Life Health Of Ny PC?
The NPI number of Active Life Health Of Ny PC is 1275814105. It was assigned on September 6, 2011 and is currently active in the NPPES registry.
What is the specialty of Active Life Health Of Ny PC?
Active Life Health Of Ny PC is registered under the primary taxonomy General Practice (code 208D00000X), licensed in TX under license number 2611911.
Where does Active Life Health Of Ny PC practice?
The practice location is 300 E Main St Ste 1, Smithtown, NY 11787-2900. The office can be reached at 631-656-8796 (phone) or 631-333-7322 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1275814105 directly on the NPPES registry website.