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General NPI Number Information
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NPI Number | 1518342724
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Entity Type | Organization
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Legal Business Name | PAINLESS, COMFORTABLE, VIGOROUS, VIBRANT, ALIVE AND HEALTHY INC
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 2083 E 19TH ST FL 2
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City | BROOKLYN
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State | NY
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Zip | 11229-3901
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Country | US
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Telephone | 718-743-2141
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Fax | 801-206-5345
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Provider Business Mailing Address
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Address Line | 2083 E 19TH ST FL 2
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City | BROOKLYN
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State | NY
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Zip | 11229-3901
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Country | US
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Telephone | 718-743-2141
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Fax | 801-206-5345
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL GROSS
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Credential |
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Telephone | 718-743-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | CA
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