Provider Demographics
NPI:1770111429
Name:LIVE LIFE NOW HEALTH GROUP PA
Entity type:Organization
Organization Name:LIVE LIFE NOW HEALTH GROUP PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MALKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-960-3553
Mailing Address - Street 1:350 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5013
Mailing Address - Country:US
Mailing Address - Phone:646-960-3553
Mailing Address - Fax:
Practice Address - Street 1:350 7TH AVE STE 600
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5013
Practice Address - Country:US
Practice Address - Phone:646-960-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty