Anti-Aging Group LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

ANTI-AGING GROUP LLC

Doing business as

Anti-Aging Wellness Clinic

Practice address

580 Sylvan Ave Ste MH
Englewood Cliffs, NJ 07632-3105

Phone

(201) 494-7532

NPI assigned

May 14, 2021

Last updated

May 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hyun Dong AhnNPI 1720685274

Title

Owner/Acupuncturist

Phone

(201) 494-7532

Specialties & licenses 1

Addresses

Other names 1

• Anti-Aging Wellness Clinic Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hyun Dong Ahn

  • Acupuncturist
  • Hackensack, NJ
  • NPI 1720685274
  NPD Authorized official

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1154995256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PARK ST APT 4A",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014346",
            "telephone_number": "201-494-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SYLVAN AVE STE MH",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323105",
            "telephone_number": "201-494-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTI-AGING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "HYUN DONG",
        "authorized_official_title_or_position": "OWNER/ACUPUNCTURIST",
        "authorized_official_telephone_number": "201-494-7532"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "antiaginggroup",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "580 Sylvan Ave Ste Mh",
            "city": "Englewood Cliffs",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076323105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Anti-Aging Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Health Service Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.