LONGEVITY MEDICAL LLC (NPI# 1972779486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972779486 |
| Entity Type | Organization |
| Organization Name | LONGEVITY MEDICAL LLC |
| Practice Address |
540 Bordentown Avenue Suite 4200 South Amboy NJ 08879-0157 |
| Practice Telephone | 7327216789 |
| Mailing Telephone | 7327216789 |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |
| Authorized Official Name | LEWIS KORB (PRESIDENT) |
| Authorized Official Telephone | 7327216789 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 25MA03609800 | NJ | Other Service Providers |
| N | 174400000X | Specialist | 26NR12059400 | NJ | Other Service Providers |
| Y | 174400000X | Specialist | 38MC00433200 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | MEDICARE IDENTIFICATION NUMBER | 088771 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386902609 | Longevity Medical LLC | Chiropractor | 572 Broadway, Long Branch, NJ 07740-5907 | 2012-04-24 |
| 1467723486 | Longevity Medical LLC | Registered Nurse | 1355 B Lynnfield Rd, Ste 245, Memphis, TN 38119-5801 | 2012-01-23 |
| Street Address |
540 BORDENTOWN AVENUE SUITE 4200 |
| City | SOUTH AMBOY |
| State | NJ |
| Zip Code | 08879-0157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659454767 | Accumed Diagnostic Laboratory Inc | Clinical Medical Laboratory | 540 Bordentown Avenue, Second Floor Suite 4, South Amboy, NJ 08879 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295206225 | Vrajesh C Desai | Pharmacist | 1 Laurence Parkway, Laurence Harbor, NJ 08879 | 2018-12-17 |
| 1033661236 | Cmp Group,pc | Chiropractor | 540 Bordentown Road Suite 4900 4thfl, South Amboy, NJ 08879 | 2016-11-04 |
| 1992153035 | Joanne Cise | Counselor | One Lower Main Street, South Amboy, NJ 08879 | 2016-05-31 |
| 1134537673 | Jeffrey Gee | Dentist | 331 South Pine Ave, Morgan, NJ 08879 | 2014-07-29 |
| 1952736985 | Venetian Care and Rehabilitation Center | Skilled Nursing Facility | 275 John O'leary Boulevard, South Amboy, NJ 08879 | 2013-09-10 |
| 1194046490 | Rifaqat Baig | Family Medicine | 963 Route 9 North, South Amboy, NJ 08879 | 2010-06-21 |
| 1033446703 | Roque Manuel Crespo Jr. | Counselor | 1 Lower Main St, South Amboy, NJ 08879 | 2009-11-17 |
| 1124278718 | Andrew Jon Mcnulty | Psychologist | 59 Raritan Reach Rd, South Amboy, NJ 08879 | 2008-09-19 |
| 1801078779 | Primary and Preventative Internal Medicine of Central New Jersey, LLC | Internal Medicine | 2045 Us Highway 35 South, South Amboy, NJ 08879 | 2007-12-03 |
| 1891904124 | South Amboy Board of Education | Local Education Agency (LEA) | 240 John Street, South Amboy, NJ 08879 | 2007-05-22 |
| Find all providers in zip 08879 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265717714 | Orthopedic Nj Rehab Pa | Specialist | 979 Us Highway 9, South Amboy, NJ 08879-3302 | 2011-10-17 |
| 1245341924 | Philip C Pollen Sr. | Specialist | 3 Athens Ave, South Amboy, NJ 08879-2401 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817356 | Erica Strubbe-montalvo | Specialist | 135 Larch Ave, Bogota, NJ 07603-1504 | 2020-10-08 |
| 1154937076 | Ines P Serna | Specialist | 7312 Kiesel Pl, North Bergen, NJ 07047-4033 | 2020-09-16 |
| 1568077238 | Michelle Horowitz-firestone | Specialist | 5 Whitman Ter, Long Branch, NJ 07740-9310 | 2020-09-10 |
| 1811509946 | Iris Devaughn | Specialist | 218 High St Apt 6, Burlington City, NJ 08016-4420 | 2020-08-19 |
| 1083223572 | Enlyv Clinics | Specialist | 908 Oak Tree Ave Ste R, South Plainfield, NJ 07080-5135 | 2020-07-30 |
| 1235748971 | North Jersey Sports Medicine & Orthopedic Center, LLC | Specialist | 254b Mountain Ave Ste 201, Hackettstown, NJ 07840-2413 | 2020-07-29 |
| 1255958864 | Tiffany Nicole Pierce | Specialist | 730 Newark Ave Apt 12d, Jersey City, NJ 07306-2816 | 2020-06-30 |
| 1699391557 | Brojan Franchising Inc | Specialist | 76 Highland Trl, Denville, NJ 07834-2033 | 2020-06-17 |
| 1487274288 | Kyle Everage | Specialist | 129 Passaic Ave # 201, Kearny, NJ 07032-1105 | 2020-04-21 |
| 1548880644 | Michal Lasowsky | Specialist | 1 Idaho St, Passaic, NJ 07055-3336 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH AMBOY |
| Zip Code | 08879 |
Please comment or provide details below to improve the information on LONGEVITY MEDICAL LLC.
| 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.