A Progressive Longevity Center,Llc

LBN: A Progressive Longevity Center,Llc
A Progressive Longevity Center,Llc is an health care organization with primary practice located at 2555 John F Kennedy Blvd D, Jersey City NJ 07304-2165. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. A Progressive Longevity Center,Llc can be contacted via phone (201) 761-0717, or through Moustiatse, Adelia via phone (201) 761-0717.

Contact Information

Primary practice address
2555 John F Kennedy Blvd D Jersey City NJ 07304-2165
Phone: (201) 761-0717
Fax: (201) 761-0787
Website:
Map and Directions
Authorized official contact:
Name: Moustiatse, Adelia Doctor of Medicine (MD)
Phone: (201) 761-0717

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MA06826400 New Jersey

Profile Details

NPI number 1568515500
LBN Legal business name A Progressive Longevity Center,Llc
DBA Doing business as
Authorized official Moustiatse, Adelia Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 21st, 2007
Last updated Mar 25th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568515500 NPPES
New Jersey MEDICAID 7866305

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