Provider Demographics
NPI:1639908973
Name:VIVIFY MEDICAL PLLC
Entity type:Organization
Organization Name:VIVIFY MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIAMINOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-480-9500
Mailing Address - Street 1:125 MAIDEN LN RM 6B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4715
Mailing Address - Country:US
Mailing Address - Phone:212-480-9500
Mailing Address - Fax:212-480-9700
Practice Address - Street 1:125 MAIDEN LN RM 6B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4715
Practice Address - Country:US
Practice Address - Phone:718-732-3634
Practice Address - Fax:718-362-1651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty