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General NPI Number Information
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NPI Number | 1639908973
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Entity Type | Organization
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Legal Business Name | VIVIFY MEDICAL PLLC
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 125 MAIDEN LN RM 6B
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City | NEW YORK
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State | NY
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Zip | 10038-4715
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Country | US
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Telephone | 718-732-3634
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Fax | 718-362-1651
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Provider Business Mailing Address
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Address Line | 125 MAIDEN LN RM 6B
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City | NEW YORK
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State | NY
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Zip | 10038-4715
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Country | US
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Telephone | 212-480-9500
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Fax | 212-480-9700
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Authorized Official
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Title or Position | OWNER
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Name | AMNON BENIAMINOVITZ
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Credential | MD
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Telephone | 212-480-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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