Organization Active NPI

Princeton Longevity Medical of New York PLLC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1205447745
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRINCETON LONGEVITY MEDICAL OF NEW YORK PLLC
Practice address
1 World Trade Ctr Ste 71D
New York, NY 10007-0089
Phone
(888) 800-0752
NPI assigned
Aug 10, 2020
Last updated
Aug 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Dr. David Fein, MDNPI 1780721704
Title
Managing Member
Phone
(888) 800-0752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1 World Trade Ctr Ste 71D
New York, NY 10007-0089

Mailing address

104 Carnegie Ctr Ste 101
Princeton, NJ 08540-6232
Phone (888) 800-0752

National Provider Directory

National Provider Directory

Locations

104 Carnegie Ctr
Ste 101
Princeton, NJ 08540

1 World Trade Ctr
Ste 71D
New York, NY 10007
Phone (888) 800-0752

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1205447745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CARNEGIE CTR STE 101",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406232",
            "telephone_number": "888-800-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR STE 71D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100070089",
            "telephone_number": "888-800-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON LONGEVITY MEDICAL OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "FEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "888-800-0752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.