| Active Life Health Of Ny Pc | |
|
300 E Main St Ste 1 Smithtown NY 11787-2900 | |
| (631) 656-8796 | |
| (631) 333-7322 |
| Full Name | Active Life Health Of Ny Pc |
|---|---|
| Speciality | General Practice |
| Location | 300 E Main St Ste 1, Smithtown, New York |
| Authorized Official Name and Position | John J Rush (OWNER) |
| Authorized Official Contact | 3019281697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Life Health Of Ny Pc 363 Route 111 Ste 107-b Smithtown NY 11787-4756 Ph: (631) 656-5544 | Active Life Health Of Ny Pc 300 E Main St Ste 1 Smithtown NY 11787-2900 Ph: (631) 656-8796 |
| NPI Number | 1275814105 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 03/04/2019 |
| Medicare PECOS PAC ID | 7810161338 |
|---|---|
| Medicare Enrollment ID | O20111119000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275814105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 2611911 (Texas) | Primary |
| Provider Name | Philip M Lenoach |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235104373 PECOS PAC ID: 5294626362 Enrollment ID: I20040320000495 |
| Provider Name | Mona Elkomos-botros |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619062171 PECOS PAC ID: 1850358383 Enrollment ID: I20050422000772 |
| Provider Name | Hubert Roman Franke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366416240 PECOS PAC ID: 9830117746 Enrollment ID: I20051109000800 |
| Provider Name | Eric Berkowitz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508805805 PECOS PAC ID: 3971508433 Enrollment ID: I20060916000087 |
| Provider Name | Majid Maybody |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083633267 PECOS PAC ID: 3971533415 Enrollment ID: I20070717000694 |
| Provider Name | Robert L Streisand |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962436485 PECOS PAC ID: 1456422740 Enrollment ID: I20080613000184 |
| Provider Name | Kirill V Rikher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578530788 PECOS PAC ID: 8325225006 Enrollment ID: I20110606000618 |
| Provider Name | Ross E Lipton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518256767 PECOS PAC ID: 9739330861 Enrollment ID: I20121119000154 |
| Provider Name | Wilder Shaw Rucker |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235403742 PECOS PAC ID: 9638314289 Enrollment ID: I20130402000146 |
| Provider Name | Anastasia Ruth Gentles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780075879 PECOS PAC ID: 2062779309 Enrollment ID: I20171122000569 |
| Provider Name | Ghada M Zaytoun |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1881072932 PECOS PAC ID: 1658613799 Enrollment ID: I20190724000617 |
| Provider Name | Muftah Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649705252 PECOS PAC ID: 0143645952 Enrollment ID: I20200810002836 |
| Provider Name | Yun Jae Cho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568826568 PECOS PAC ID: 6800216839 Enrollment ID: I20201013003028 |
| Provider Name | John J Rush |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851337281 PECOS PAC ID: 9739085838 Enrollment ID: I20201209001363 |
| Provider Name | Monish Merchant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609187186 PECOS PAC ID: 9436444320 Enrollment ID: I20230301001662 |
Raul R. Trinchet, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 285 Middle Country Road, Suite Ll-2, Smithtown, NY 11787 Phone: 631-979-4541 Fax: 631-979-4546 | |
Pilip Medical Treatments P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Smithtown Byp Ste 305, Smithtown, NY 11787 Phone: 631-656-9040 Fax: 631-648-9661 | |
Omni Medical 360 Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Maple Ave, Smithtown, NY 11787 Phone: 631-813-7788 | |
Optimum Care Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 321 E Main St Ste 1, Smithtown, NY 11787 Phone: 631-265-4606 Fax: 631-265-4675 | |
Long Island Gastroenterology And Liver Disease P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 48 Route 25a Ste 307, Smithtown, NY 11787 Phone: 631-265-0062 Fax: 631-265-0590 | |
Infectious Disease Medical Practice Of Ny Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 48 Route 25a, Suite 308, Smithtown, NY 11787 Phone: 631-864-6111 Fax: 631-864-5004 | |
Vp Medical, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Gilbert Ave, Smithtown, NY 11787 Phone: 347-987-1168 |