# LIVING WELL NEW YORK MEDICAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972994911
- **Authorized official:** DAN THOMAS (BILLING MANAGER)
- **Authorized official phone:** (212) 645-8151

## Contact information

- **Practice address:** 632 BROADWAY, STE. 303, NEW YORK, NY 10012-2614
- **Practice address phone:** (212) 645-8151
- **Practice address fax:** (212) 777-1653
- **Mailing address:** 632 BROADWAY, STE. 303, NEW YORK, NY 10012-2614
- **Mailing address phone:** (212) 645-8151
- **Mailing address fax:** (212) 777-1653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2015
- **Last updated:** 02/12/2015