Living Well Medical Support LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

25MA05520200 Issued in NJ

Legal business name

LIVING WELL MEDICAL SUPPORT LLC

Practice address

78 Easton Ave
First Floor
New Brunswick, NJ 08901-1885

Phone

(732) 828-1003

Fax

(732) 828-0775

NPI assigned

Sep 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Alfred T. C. Peng, M.D.

Title

Manager

Phone

(561) 251-6781

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1609026798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 HIDDEN WOODS CT",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088543060",
            "telephone_number": "561-251-6781",
            "fax_number": "561-994-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 EASTON AVE",
            "address_2": "FIRST FLOOR",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011885",
            "telephone_number": "732-828-1003",
            "fax_number": "732-828-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL MEDICAL SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "T. C.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-251-6781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NJ",
            "license": "25MA05520200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Little Hands and Creations LLC
• Nyesha Marie Little
• Katherine Liu, MD
• Michael Liu, PHARMD
• Wen Liu, APN
• Johanna Llanas
• Evan Lobato, ATC
• Gabriella Rose Lobitz, MD
• Itohan Cindy Locklear, APN
• Philomena Aynslie Loescher

• Exclusive Provider Organization in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Exclusive Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.