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Individual

PAUL D LIVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
622 W 168TH ST PH 11, NEW YORK, NY 10032-3720
(914) 787-3283
(212) 304-7050
Mailing address
202 12TH ST APT 2, PALISADES PARK, NJ 07650-2047
(201) 207-3819

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003108-1
NY

Other

Enumeration date
03/14/2023
Last updated
03/14/2023
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