Advanced Rejuvenation Therapy
Organization Active NPI Orthopaedic Surgery Physician · Newtown, CT
NPI 1063137271 · NPPES record last updated Aug 11, 2023
Key facts
- NPI
- 1063137271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ADVANCED REJUVENATION THERAPY
- Practice address
- 32 Church Hill Rd BLDG E
Newtown, CT 06470-1638 - Phone
- (203) 491-2999
- NPI assigned
- Oct 10, 2022
- Organization subpart
- No
Authorized official
- Name
- Gary Garofalo, OWNER
- Title
- Authorized Offcial
- Phone
- (203) 309-9378
Practitioners 5
-
Taylor Schaake, APRN
-
Aimee Jaquez, PAC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230203000404 | CT | Part B Supplier - Clinic/Group Practice | 4789056565 |
Receives reassigned benefits from 5 practitioners Practice locations: Newtown, CT |
National Provider Directory
Locations
10 Waterside Dr
Ste 100
Farmington, CT 06032
Phone (203) 491-2999
32 Church Hill Rd
Bldg E
Newtown, CT 06470
Phone (203) 491-2999
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Pain Clinic/Center | 261QP3300X |
Addresses
Primary practice location
32 Church Hill Rd BLDG E
Newtown, CT 06470-1638
Mailing address
32 Church Hill Rd BLDG E
Newtown, CT 06470-1638
Phone (203) 491-2999
Other practice location 1
10 Waterside Dr Ste 100
Farmington, CT 06032-3056
Phone (203) 491-2999
Other names
- BioRestore
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- Brianna Fox Agnello
- Alejandro E Isgut MD LLC
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All providers in Newtown, CT · Orthopaedic Surgery Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.