Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Active Life Health of Ny PC

Organization General Practice Physician · NPI 1275814105

Active Life Health of Ny PC is a General Practice Physician in Smithtown, New York. Works from 3 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

300 E Main St Ste 1
Smithtown, NY 11787-2900
Phone: (631) 656-8796
Fax: (631) 333-7322
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 57 W 57th St Ste 1603, New York, NY 10019-2833 — (631) 656-8796
  • 363 Route 111, Smithtown, NY 11787-4756 — (631) 656-5544

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 2611911 (TX)

Record details

NPI number1275814105
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Rush — Owner · (301) 928-1697
NPI enumeratedSeptember 6, 2011
Last updated in NPPESMarch 4, 2019
Mailing address363 Route 111, Ste 107-B, Smithtown, NY 11787-4756

Other providers in Smithtown