Active Life Medical PLLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE LIFE MEDICAL PLLC

Practice address

311 North St Ste 406
White Plains, NY 10605-2217

Phone

(914) 785-7752

Fax

(914) 363-0966

NPI assigned

Aug 4, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John J Rush

Title

Chairman & Chief Executive Officer

Phone

(301) 928-1697

Specialties & licenses 1

Addresses

Other names 1

• ARTHRITIS KNEE PAIN CENTERS Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1104436237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 406",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052217",
            "telephone_number": "914-785-7752",
            "fax_number": "914-363-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 406",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052217",
            "telephone_number": "914-785-7752",
            "fax_number": "914-363-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHAIRMAN & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-928-1697"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARTHRITIS KNEE PAIN CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daphne Michelle Acevedo
• Vanessa Acietuno
• Lindsey Ackert
• Yuk King Acon
• Active Life Health of Garden City Medical PLLC
• Active Life Medical, PLLC
• Diane Adams
• Georgina Francine Adams
• Tye Addison
• Gerard Addonizio, MD

• Durable Medical Equipment & Medical Supplies in White Plains, NY
• Providers in White Plains, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.