Healthcare Provider Details

I. General information

NPI: 1881518496
Provider Name (Legal Business Name): LIFE MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 2ND ST APT E809
MINEOLA NY
11501-6005
US

IV. Provider business mailing address

199 2ND ST APT E809
MINEOLA NY
11501-6005
US

V. Phone/Fax

Practice location:
  • Phone: 212-920-5909
  • Fax: 212-920-5909
Mailing address:
  • Phone: 212-920-5909
  • Fax: 212-920-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SRINIVAS B RAO
Title or Position: OWNER
Credential:
Phone: 212-920-5909