Healthcare Provider Details

I. General information

NPI: 1770111429
Provider Name (Legal Business Name): LIVE LIFE NOW HEALTH GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 LEWIS ST # 2
YONKERS NY
10703-1627
US

IV. Provider business mailing address

26 LEWIS ST # 2
YONKERS NY
10703-1627
US

V. Phone/Fax

Practice location:
  • Phone: 917-529-2030
  • Fax: 646-844-1991
Mailing address:
  • Phone: 917-529-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM MALKIN
Title or Position: OWNER
Credential: MD
Phone: 917-529-2030