HEALTHY LIFE AND LONGEVITY MEDICAL OFFICE P.C. (NPI# 1538586771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538586771 |
| Entity Type | Organization |
| Organization Name | HEALTHY LIFE AND LONGEVITY MEDICAL OFFICE P.C. |
| Other Organization Name | MAXIUM LIFE WELLNESS CENTER AND MEDICAL SPA |
| Practice Address |
287 Northern Blvd Suit 106 Great Neck NY 11021-4700 |
| Mailing Address |
287 Northern Boulevards Suit 106 Great Neck NY 11021-4347 |
| Practice Telephone | 9175796886 |
| Mailing Telephone | 9175796886 |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |
| Authorized Official Name | ZHICHENG LU (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9175796886 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
233928 | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Maxium Life wellness center and medical spa | Doing Business As Name - Organization |
| Street Address |
287 NORTHERN BLVD SUIT 106 |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11021-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508869884 | Guy L Mintz | Internal Medicine | 287 Northern Blvd, Ste 211, Great Neck, NY 11021-4717 | 2005-05-31 |
| 1730550476 | Alan Feller | General Practice | 287 Northern Blvd, Suite 200, Great Neck, NY 11021-4700 | 2015-10-07 |
| 1265809636 | Robert Rahmani Heart & Vascular PC | Specialist | 287 Northern Blvd, Suite 108, Great Neck, NY 11021-4700 | 2015-09-01 |
| 1386023844 | New York Eye Care & Surgery PC | Ophthalmology | 287 Northern Blvd, Great Neck, NY 11021-4700 | 2015-05-29 |
| 1346637790 | Bh Physical Therapy Pllc | Physical Therapist | 287 Northern Blvd, Suite 105, Great Neck, NY 11021-4700 | 2015-04-23 |
| 1518350552 | Feller Medical, PC | Clinic/Center | 287 Northern Blvd, Suite 200, Great Neck, NY 11021-4700 | 2015-03-16 |
| 1932518818 | Perela Kahen | Physical Therapist | 287 Northern Blvd, Suite 105, Great Neck, NY 11021-4700 | 2014-08-05 |
| 1841582079 | Angela Azar Md PC | Specialist | 287 Northern Blvd, Great Neck, NY 11021-4717 | 2011-05-05 |
| 1396071825 | Ny Center for Behavioral Health, Inc. | Psychologist | 287 Northern Blvd, Suite 100, Great Neck, NY 11021-4717 | 2009-10-17 |
| 1013171065 | Guy L. Mintz M.d. Pllc | Specialist | 287 Northern Blvd, Suite 211, Great Neck, NY 11021-4717 | 2008-07-17 |
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| 1518457530 | Assured Quality Home Care, Inc. | In Home Supportive Care | 885 Northern Blvd., Greak Neck, NY 11021 | 2018-05-15 |
| 1881183275 | Liat Mindy Brody | Occupational Therapist | 7 Hickory Dr, Great Neck, NY 11021 | 2018-05-01 |
| 1457853707 | Allison Squillace | Social Worker | 7 Bond Suite 1a, Great Neck, NY 11021 | 2018-03-02 |
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| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| City | GREAT NECK |
| Zip Code | 11021 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.