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Contact Information

ACTIVELIFE REGENERATIVE THERAPIES
413 WANAQUE AVE
POMPTON LAKES, NJ07442-1844
 Phone: 973-997-0542
 Fax: 973-831-6763
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ACTIVELIFE REGENERATIVE THERAPIES · (Female)

NPI # 1225708886
Status Active
Credentials
Entity Individual
Enumeration date 09/15/2021
Last updated 01/05/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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