New Lifestyle Medical PA

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

25MA05661500 Issued in NJ

Legal business name

NEW LIFESTYLE MEDICAL PA

Practice address

19-21 Fair Lawn Ave
Ste 2E
Fair Lawn, NJ 07410-2331

Phone

(201) 468-8808

Fax

(201) 815-2520

NPI assigned

Apr 24, 2013

Organization subpart

No

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

Authorized official

Name

Igor Gefter, M.D.

Title

Medical Director

Phone

(201) 468-8808

Specialties & licenses 9

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Frederick Elliot Kahn, M.D.

  • Psychosomatic Medicine Physician
  • Paramus, NJ
  • NPI 1316160039
  NPD (past)

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1134563802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "address_2": "STE 2E",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-468-8808",
            "fax_number": "201-815-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "address_2": "STE 2E",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-468-8808",
            "fax_number": "201-815-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFESTYLE MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "GEFTER",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-468-8808",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA06438600",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "25MA06438600",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "25MA06438600",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA06438600",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NJ",
            "license": "25MA05661500",
            "primary": true
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NJ",
            "license": "25MA05661500",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NJ",
            "license": "25MA05661500",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA05661500",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NJ",
            "license": "25MA05661500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348341",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Jersey Associates in Medicine, PA
• New Jersey Back Institute
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• New Jersey CVS Pharmacy LLC
• New Jersey Endosurgical Spine and Pain Center LLC
• Andrew Boro Ngugi
• Josh M Nguyen
• Nicole E. Grace, LCSW, Psya, LLC
• Urszula Nieznalska, PT
• Jennifer Nims

• Addiction Medicine (Psychiatry & Neurology) Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.