| Genesis Integrative Medicine Longevity Center Llc | |
|
1716 Main St Lake Como NJ 07719-3052 | |
| (732) 681-1000 | |
| (732) 681-1004 |
| Full Name | Genesis Integrative Medicine Longevity Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1716 Main St, Lake Como, New Jersey |
| Authorized Official Name and Position | Joseph Louro (CHIROPRACTOR) |
| Authorized Official Contact | 7326811000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Integrative Medicine Longevity Center Llc 1716 Main St Lake Como NJ 07719-3052 Ph: (732) 681-1000 | Genesis Integrative Medicine Longevity Center Llc 1716 Main St Lake Como NJ 07719-3052 Ph: (732) 681-1000 |
| NPI Number | 1578299558 |
|---|---|
| Provider Enumeration Date | 08/01/2022 |
| Last Update Date | 11/04/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 6305213497 |
|---|---|
| Medicare Enrollment ID | O20221102001569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578299558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Salvatore Pepe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609809458 PECOS PAC ID: 3779616578 Enrollment ID: I20100730000430 |
| Provider Name | Joseph Louro |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881688984 PECOS PAC ID: 3173710720 Enrollment ID: I20101208000262 |
| Provider Name | John Salerno |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1285746669 PECOS PAC ID: 9133119936 Enrollment ID: I20210901002359 |
Mental Healthcare Connections Of New Jersey, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 21st Ave, Lake Como, NJ 07719 Phone: 732-586-1054 |