Provider Demographics
NPI:1235514043
Name:CHS NY MEDICAL P C
Entity Type:Organization
Organization Name:CHS NY MEDICAL P C
Other - Org Name:LIVE WELL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CORNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-468-6248
Mailing Address - Street 1:5500 MARYLAND WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 LIBERTY ST
Practice Address - Street 2:20TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10281-1008
Practice Address - Country:US
Practice Address - Phone:212-635-7766
Practice Address - Fax:212-635-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty