REJUVENATION CENTER FOR MIND AND BODY (NPI# 1013475953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013475953 |
| Entity Type | Organization |
| Organization Name | REJUVENATION CENTER FOR MIND AND BODY |
| Practice Address |
555 Preakness Ave Totowa NJ 07502-1012 |
| Practice Telephone | 9734444558 |
| Practice Fax Number | 9734447466 |
| Mailing Telephone | 9734444558 |
| Mailing Fax Number | 9734447466 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Authorized Official Name | EUGENE FESTA (OWNER) |
| Authorized Official Telephone | 9734444558 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
555 PREAKNESS AVE |
| City | TOTOWA |
| State | NJ |
| Zip Code | 07502-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457769705 | Ms Integrated Psychotherapy and Counseling | Psychiatry & Neurology | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2014-07-31 |
| 1760890164 | Melissa Rivera | Psychologist | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2014-07-29 |
| 1750724837 | Ms Integrated Psychotherapy and Counseling LLC | Psychologist | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2013-04-09 |
| 1184976391 | Ms Integrated Psychotherapy and Counseling LLC | Counselor | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2012-10-11 |
| 1457623225 | Client Action & Resource Empowerment | Clinic/Center | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2012-02-08 |
| 1932495447 | Caroline Perez | Social Worker | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2011-06-22 |
| 1336468958 | Journey To Freedom | Counselor | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2010-05-21 |
| 1932428620 | Rey Ruiz | Counselor | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2010-05-20 |
| 1114240967 | M&s Outpatient Services | Counselor | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2010-03-09 |
| 1386967628 | Alain Mollinedo | Social Worker | 555 Preakness Ave, Totowa, NJ 07502-1012 | 2010-03-01 |
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| 1851535934 | Dolores Boisselle | Audiologist | 202 Uion Ave, B.u.i.l.d. Academy, Paterson, NJ 07502 | 2009-04-21 |
| 1699855494 | Donald J Pasquariello | Dentist | 55 Union Ave, Paterson, NJ 07502 | 2006-10-16 |
| 1629094255 | Pb Pharmacy | Pharmacy | 222 Union Avenue, Paterson, NJ 07502 | 2006-07-15 |
| 1699138339 | Future Project | Day Training, Developmentally Disabled Services | 155 Union Ave, Paterson, NJ 07502 | 2016-03-31 |
| 1679653471 | Roland C Pasquariello | Dentist | 55 Union Ave, Paterson, NJ 07502 | 2006-10-16 |
| 1487790085 | Francis Tsao | Otolaryngology | 311 Lexington Ave, Paterson, NJ 07502-1010 | 2007-01-30 |
| 1225217219 | James Labagnara Md Pa | Otolaryngology | 311 Lexington Ave, Paterson, NJ 07502-1010 | 2007-10-26 |
| 1043787864 | Nj Transportation | Non-emergency Medical Transport (VAN) | 351 Linwood Ave, Paterson, NJ 07502-1023 | 2018-10-30 |
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| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
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| 1538474408 | Jerry Thomas Md and Associates | Internal Medicine | 134-6 Franklin Corner Road, Lawrenceville, NJ 08648-5246 | 2010-08-16 |
| 1811151269 | Joseph Durso Coffineau | Internal Medicine | 336 S Pitney Rd, Galloway, NJ 08205-9628 | 2008-07-15 |
| 1619051711 | David Canavan | Internal Medicine | Professional Assistance Program of Nj, 742 Alexander Road, Princeton, NJ 08650 | 2006-10-25 |
| 1245345743 | Michael S Deshields | Internal Medicine | 801 New York Ave, Trenton, NJ 08638-3913 | 2006-08-21 |
| 1285674010 | Peter O Kuponiyi | Internal Medicine | 2626 Tilton Rd, Egg Harbor Township, NJ 08234-1829 | 2006-06-08 |
| 1588647143 | David P Russo | Internal Medicine | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2005-11-28 |
| 1154851475 | Admed Centers LLC | Internal Medicine | 152 Central Ave, Clark, NJ 07066-1115 | 2017-06-19 |
| 1215479308 | Initia Nova Medical Solutions | Internal Medicine | 1930 Marlton Pike E, Cherry Hill, NJ 08003-2150 | 2016-11-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.