LONGEVITY MEDICAL LLC NPI 1972779486

NPI Information

  • NPI: 1972779486
  • Provider Name: LONGEVITY MEDICAL LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 540 BORDENTOWN AVENUE
    SUITE 4200
    SOUTH AMBOY, NJ
    ZIP 08879
  • Phone: (732) 721-6789

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NPI Details

LONGEVITY MEDICAL LLC is a specialist in South Amboy, NJ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LONGEVITY MEDICAL LLC NPI is 1972779486. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

540 BORDENTOWN AVENUE
SUITE 4200
SOUTH AMBOY, NJ
ZIP 08879-157
Phone: (732) 721-6789

The provider's authorized official is Lewis Korb .
The authorized official title is President and has the following contact phone number (732) 721-6789.

The enumeration date for this NPI number is 5/5/2008 and was last updated on 5/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist25MA03609800NEW JERSEYNo
2174400000XSpecialist26NR12059400NEW JERSEYNo
3174400000XSpecialist38MC00433200NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1088771OTHERNEW JERSEYMEDICARE IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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