Active Aging Medical Group INC
Clinic/Center, Medical Specialty in Newark, New Jersey
1720368772- Practice location
- 188 Jefferson St, Suite# 111, Newark, NJ 07105-1622
- Phone
- 732-425-3564
- Fax
- 212-238-7760
- Last updated
- August 23, 2011
Active Aging Medical Group INC is a healthcare organization based in Newark, NJ. Active Aging Medical Group INC practices in Newark, NJ. The NPI Number for Active Aging Medical Group INC is 1720368772. The current practice location address for Active Aging Medical Group INC is 188 Jefferson St, Suite# 111, Newark, NJ 07105-1622 and can be reached out via phone at 732-425-3564 and via fax at 212-238-7760.
Provider Profile Details
- NPI Number
- 1720368772
- Provider Name
- Active Aging Medical Group INC
- Provider Entity Type
- Organization
- Address
- 188 Jefferson St, Suite# 111, Newark, NJ 07105-1622
- Phone Number
- 732-425-3564
- Fax Number
- 212-238-7760
- Primary Taxonomy
- Clinic/Center, Medical Specialty · 261QM2500X
- Organization Subpart
- No
- Authorized Official
- Alexander Kolessa, MD · Chief Medical Officer · 732-425-3564
- Provider Enumeration Date
- August 23, 2011
- Last Update Date
- August 23, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 188 Jefferson St
Suite# 111
Newark, NJ 07105-1622 - City
- Newark
- State
- New Jersey
- Zip
- 07105-1622
- Phone Number
- 732-425-3564
- Fax Number
- 212-238-7760
Provider Business Mailing Address Details
- Address
- 188 Jefferson St
Suite# 111
Newark, NJ 07105-1622 - City
- Newark
- State
- NJ
- Zip
- 07105-1622
- Phone Number
- 732-425-3564
- Fax Number
- 212-238-7760
License Information
- Taxonomy
- Clinic/Center, Medical Specialty · 261QM2500X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Active Aging Medical Group INC?
The NPI number of Active Aging Medical Group INC is 1720368772. It was assigned on August 23, 2011 and is currently active in the NPPES registry.
What is the specialty of Active Aging Medical Group INC?
Active Aging Medical Group INC is registered under the primary taxonomy Clinic/Center, Medical Specialty (code 261QM2500X).
Where does Active Aging Medical Group INC practice?
The practice location is 188 Jefferson St, Suite# 111, Newark, NJ 07105-1622. The office can be reached at 732-425-3564 (phone) or 212-238-7760 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1720368772 directly on the NPPES registry website.