Organization · NPI-2

Active Life Health Of Manhattan Medical PLLC

Physical Medicine & Rehabilitation · New York, NY

NPI number1326692849
StatusActive
Last updated in NPPESNov 12, 2021

Details

NPI
1326692849
Entity type
Organization (NPI-2)
Legal business name
Active Life Health Of Manhattan Medical PLLC
Organization subpart
No
Enumeration date
Aug 1, 2019
Certification date
Nov 12, 2021
Last updated
Nov 12, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes

Practice location

57 W 57th St Ste 611
New York, NY 10019-2802

Phone 646-846-7444 · Fax 646-571-0807

Mailing address

Po Box 772223
Detroit, MI 48277-2223

Authorized official

John J Rush
Owner
6465869333

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