Provider Demographics
NPI:1194697433
Name:MYLYFE HEALTH MA PC
Entity type:Organization
Organization Name:MYLYFE HEALTH MA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, TREASURER, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLUTE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:888-232-3120
Mailing Address - Street 1:1111 ELM ST STE 12
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1540
Mailing Address - Country:US
Mailing Address - Phone:844-469-5933
Mailing Address - Fax:
Practice Address - Street 1:100 FOXBOROUGH BLVD
Practice Address - Street 2:
Practice Address - City:FOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:02035-2882
Practice Address - Country:US
Practice Address - Phone:844-469-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty