Longevity Medical Group, P.a.

NPI #1811229875 in Paramus, New Jersey

Provider Information

NPI Number: 1811229875
Entity Type: Organization
Organization Name: Longevity Medical Group, P.a.
Primary Specialty: Specialist
Enumeration Date: Feb 2, 2010
Last Updated: Feb 2, 2010

Practice Location

Address: 2 SEARS DR
City: Paramus
State: New Jersey
ZIP Code: 07652-3539
Phone: (201) 265-4647

Authorized Official

Name: DR. ROGER HOWARD COLETTI, MD
Title: PRESIDENT
Phone: (201) 265-4647

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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