NPIMap

Organization Active NPI

Longevity Medical LLC

  • Chiropractor
  • Long Branch, NJ
National Provider Identifier
1386902609
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC04332 Issued in NJ
Legal business name
LONGEVITY MEDICAL LLC
Practice address
572 Broadway
Long Branch, NJ 07740-5907
Phone
(732) 963-9806
Fax
(732) 963-9809
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Authorized official

Name
Dr. Lewis S. Korb, D.C.NPI 1760553051
Title
Owner/Chiropractor
Phone
(732) 963-9806

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
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X MC04332 NJ Primary

Addresses

Primary practice location

572 Broadway
Long Branch, NJ 07740-5907

Mailing address

572 Broadway
P.O. Box 4066
Long Branch, NJ 07740-5907
Phone (732) 963-9806

National Provider Directory

National Provider Directory

Locations

572 Broadway
Long Branch, NJ 07740
Phone (732) 963-9806

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1386902609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 BROADWAY",
            "address_2": "P.O. BOX 4066",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405907",
            "telephone_number": "732-963-9806",
            "fax_number": "732-963-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 BROADWAY",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405907",
            "telephone_number": "732-963-9806",
            "fax_number": "732-963-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "KORB",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "732-963-9806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC04332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.