Provider Demographics
NPI:1336735406
Name:PALIALIFE
Entity Type:Organization
Organization Name:PALIALIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:EL HACHEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:162-304-0102
Mailing Address - Street 1:44 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4039
Mailing Address - Country:US
Mailing Address - Phone:216-230-4010
Mailing Address - Fax:704-438-9263
Practice Address - Street 1:44 VERNON AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4039
Practice Address - Country:US
Practice Address - Phone:216-230-4010
Practice Address - Fax:704-438-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty