MEDICARE: HEALTHY LIFE MEDICAL P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	205117	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578593489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY LIFE MEDICAL P.C.

Provider Business Mailing Address
First Line	:	476 SAINT GEORGE RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-1525
Country	:	US
Telephone Number	:	718-667-6807
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2119
Country	:	US
Telephone Number	:	718-431-0014
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SEMEN AVSHALUMOV
Credential	:	M.D.
Telephone Number	:	718-667-6807

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1922083880 — DR. SAM WEISSMAN MD
Practice Location Address:

202 FOSTER AVE
BROOKLYN, NY
11230-2119

Practice Phone: 718-854-5100
Practice Fax: 718-854-6200

1982653812 — DR. DOV SHMUKLER M.D.
Practice Location Address:

202 FOSTER AVE , SUITE D
BROOKLYN, NY
11230-2119

Practice Phone: 718-431-8936
Practice Fax:

1396796694 — EXCLUSE CARE MEDICAL P.C.
Practice Location Address:

202 FOSTER AVE , STE B
BROOKLYN, NY
11230-2119

Practice Phone: 718-338-0014
Practice Fax:

1407882749 — DISA MEDICAL, P.C.
Practice Location Address:

202 FOSTER AVE , SUITE B
BROOKLYN, NY
11230-2119

Practice Phone: 718-431-0014
Practice Fax: 718-431-1799

1457371783 — MS. IRINA VOSKOBOYNIK LCSW
Practice Location Address:

202 FOSTER AVE , SUITE A
BROOKLYN, NY
11230-2119

Practice Phone: 718-854-3005
Practice Fax: 718-854-9803

1205952785 — WEISSMAN ENDOSCOPY OBS, LLC
Practice Location Address:

202 FOSTER AVE , SUITE C
BROOKLYN, NY
11230-2119

Practice Phone: 718-854-5100
Practice Fax: 718-854-6200

Directions to “HEALTHY LIFE MEDICAL P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.