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ACTIVE LIFE HEALTH OF NY PC
NPI 1275814105
General Practice in Smithtown, NY

Active since September 06, 2011
300 E MAIN ST STE 1, SMITHTOWN, NY 11787(631) 656-8796(631) 333-7322 Get Directions Write a Review

NPPES record last updated: March 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2019, May 18, 2016 (2 updates tracked since 2016).

About Active Life Health Of Ny Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACTIVE LIFE HEALTH OF NY PC (NPI 1275814105) is a healthcare organization registered as a general practice in Smithtown, New York and active in the NPI registry since September 2011. The organization maintains 2 additional practice locations and lists John J Rush, Owner, as its authorized official.

NPPES Registry Identity

NPI1275814105
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameACTIVE LIFE HEALTH OF NY PC
Location Address300 E MAIN ST STE 1Smithtown, NY 11787-2900
Mailing Address363 Route 111, Ste 107-bSmithtown, NY 11787-4756 · (631) 656-5544 · Fax (631) 656-5545
Phone(631) 656-8796
Fax(631) 333-7322
Organization SubpartNo
Authorized OfficialJohn J RushOwner · (301) 928-1697
Enumeration DateSeptember 6, 2011
Last NPPES UpdateMarch 4, 20192 updates tracked since enumeration
✔ NPI 1275814105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in TX · 2611911
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
300 E MAIN ST STE 1, Smithtown, NY 11787
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Secondary Practice Locations 2

Location 157 W 57th St Ste 1603New York, NY 10019-2833 · Phone (631) 656-8796 · Fax (631) 333-7322
Location 2363 Route 111, STE 107-BSmithtown, NY 11787-4756 · Phone (631) 656-5544 · Fax (631) 656-5545

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACTIVE LIFE HEALTH OF NY PC
Durable Medical Equipment & Medical Supplies
300 E MAIN ST STE 1
SMITHTOWN, NY 11787
Suffolk County (631) 656-8796

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Active Life Health Of Ny PC's NPI number?

The NPI number for Active Life Health Of Ny PC is 1275814105. It was assigned to this organization in the NPPES registry on September 6, 2011.

Where is Active Life Health Of Ny PC located?

Active Life Health Of Ny PC is located at 300 E Main St Ste 1, Smithtown, NY 11787. The listed phone number is (631) 656-8796.

What is Active Life Health Of Ny PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Active Life Health Of Ny PC was last updated on March 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.