Healthy Living, PC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

HEALTHY LIVING, PC

Practice address

1715 Route 17M
Goshen, NY 10924-2526

Phone

(845) 393-1167

Fax

(888) 960-5246

NPI assigned

Dec 28, 2018

Organization subpart

No

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

Authorized official

Name

David Israel

Title

Owner

Phone

(845) 239-1167

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Debra Supenski, Practice Manager Other name
• Healthy Living for a Healthy Life Other name

Locations

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1689146896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CYNTHIA CT",
            "city": "FLORIDA",
            "state": "NY",
            "postal_code": "109211612",
            "telephone_number": "845-239-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 ROUTE 17M",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242526",
            "telephone_number": "845-393-1167",
            "fax_number": "888-960-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-239-1167"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02426539",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Debra Supenski, Practice Manager",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Healthy Living for a Healthy Life",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Margaret Pagan Hassler, RN
• Sophia Marie Hawkins
• Cara Hayden
• Heather Jo-Ann Healey
• Healthspine and Anesthesia Institute
• Joan Hearn-Parks, LCSW
• Madline M Helms, COTA
• Shane Henderson, DPT
• Robert Charles Hendler, MD
• Kayla Pennington Henke, LMSW, CASAC

• Emergency Medicine Physician in Goshen, NY
• Providers in Goshen, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.