Provider Demographics
NPI:1811927627
Name:ART OF LIFE INC
Entity type:Organization
Organization Name:ART OF LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-552-9077
Mailing Address - Street 1:2750 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2301
Mailing Address - Country:US
Mailing Address - Phone:215-552-9009
Mailing Address - Fax:888-893-4563
Practice Address - Street 1:2750 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2301
Practice Address - Country:US
Practice Address - Phone:215-552-9009
Practice Address - Fax:888-893-4563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019025000005Medicaid
PA049145Medicare PIN