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Contact Information

ACTIVE LIFE MEDICAL, PLLC
311 NORTH ST STE 406
WHITE PLAINS, NY10605-2217
 Phone: 914-785-7752
 Fax: 914-363-0966
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ACTIVE LIFE MEDICAL, PLLC

NPI # 1417577479
LBN Legal business name ACTIVE LIFE MEDICAL, PLLC
Authorized official JOHN RUSH - (CHAIRMAN & CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/20/2020
Last updated 04/20/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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