Provider Demographics
NPI:1235700485
Name:AVIV HEALTH LLC
Entity Type:Organization
Organization Name:AVIV HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-496-5589
Mailing Address - Street 1:28 FLANNERY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4750
Mailing Address - Country:US
Mailing Address - Phone:732-267-8747
Mailing Address - Fax:
Practice Address - Street 1:28 FLANNERY AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4750
Practice Address - Country:US
Practice Address - Phone:732-267-8747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty