Provider Demographics
NPI:1407644701
Name:NEW LIFE MEDICAL, PLLC
Entity type:Organization
Organization Name:NEW LIFE MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-866-3377
Mailing Address - Street 1:120 EAST AVE STE 1E
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5786
Mailing Address - Country:US
Mailing Address - Phone:203-866-3377
Mailing Address - Fax:
Practice Address - Street 1:120 EAST AVE STE 1E
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5786
Practice Address - Country:US
Practice Address - Phone:203-866-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty