ACTIVE LIFE HEALTH OF NY PC

SMITHTOWN, NY
NPI1275814105
Entity TypeOrganization
Authorized ContactJOHN J RUSH
Owner
301-928-1697
Organization Subpart ?No
Primary Taxonomy208D00000X General Practice
(Licence: TX  2611911)
Enumeration Date2011-09-06
Last Update Date2019-03-04
Business Address
ACTIVE LIFE HEALTH OF NY PC
300 E MAIN ST STE 1
SMITHTOWN, NY 11787-2900
Phone number: 631-656-8796
Mailing Address
ACTIVE LIFE HEALTH OF NY PC
363 ROUTE 111 STE 107-B
SMITHTOWN, NY 11787-4756
Phone number: 631-656-5544
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