Organization
HEALTHY LIVING, PC
Active
Other names
Debra Supenski, Practice Manager, Healthy Living for a Healthy Life
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ISRAEL (OWNER)
(845) 239-1167
Entity
Organization
Contact information
Practice address
1715 ROUTE 17M, GOSHEN, NY 10924-2526
(845) 393-1167
(888) 960-5246
Mailing address
4 CYNTHIA CT, FLORIDA, NY 10921-1612
(845) 239-1167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02426539
—
NY
Enumeration date
12/28/2018
Last updated
06/12/2020
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