Healthcare Provider Details

I. General information

NPI: 1740774504
Provider Name (Legal Business Name): LIFE TECH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 EAGLE ROCK AVE STE 200
EAST HANOVER NJ
07936-3159
US

IV. Provider business mailing address

120 EAGLE ROCK AVE STE 200
EAST HANOVER NJ
07936-3159
US

V. Phone/Fax

Practice location:
  • Phone: 551-225-0080
  • Fax:
Mailing address:
  • Phone: 551-225-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DOV BRAFMAN
Title or Position: CEO
Credential:
Phone: 973-200-3045