Rejuvenation Center for Mind and Body

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

REJUVENATION CENTER FOR MIND AND BODY

Practice address

555 Preakness Ave
Totowa, NJ 07502-1012

Phone

(973) 444-4558

Fax

(973) 444-7466

NPI assigned

Mar 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eugene FestaNPI 1629395629

Title

Owner

Phone

(973) 444-4558

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eugene Daniel Festa, M.D., PH.D

  • Internal Medicine Physician
  • Wayne, NJ
  • NPI 1629395629
  Medicare reassignment NPD Authorized official
• Laurie Kupryk, PA-C

  • Physician Assistant
  • Springfield, NJ
  • NPI 1891289914
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1013475953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PREAKNESS AVE",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075021012",
            "telephone_number": "973-444-4558",
            "fax_number": "973-444-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PREAKNESS AVE",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075021012",
            "telephone_number": "973-444-4558",
            "fax_number": "973-444-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION CENTER FOR MIND AND BODY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "FESTA",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-444-4558"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Raba, DPT
• Rasraj Rana, O.D.
• Salvatore Rappa, RPH
• Indira Ravishankar, M.D.
• Toni Anne Raymond, DMD
• Marlene E Reyes, DOULA
• Melanie Elisie Reyes, AGACNP
• Kristin Ribe
• Jackeline Victoria Rodriguez, NP
• Roland a Ghanem,MD LLC

• Addiction Medicine (Internal Medicine) Physician in Totowa, NJ
• Providers in Totowa, NJ by specialty
• Addiction Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.