Prohealthlife Medical PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

011734 Issued in NY

Legal business name

PROHEALTHLIFE MEDICAL PLLC

Practice address

1783 W 6TH St
Brooklyn, NY 11223-1321

Phone

(718) 645-2555

NPI assigned

Aug 19, 2013

Organization subpart

No

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

Authorized official

Name

Rajendra Damodar Bhayani, MD

Title

President

Phone

(718) 249-9383

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1952734584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 W 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 W 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231321",
            "telephone_number": "718-645-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTHLIFE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "BHAYANI",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "DAMODAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-249-9383",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "011734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.