Revitalize Medical Aesthetics and Wellness Spa

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

REVITALIZE MEDICAL AESTHETICS AND WELLNESS SPA

Practice address

3435 US Highway 9 Unit 4
Freehold, NJ 07728-3285

Phone

(732) 835-2209

Fax

(848) 444-9218

NPI assigned

Feb 9, 2024

Organization subpart

No

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

Authorized official

Name

Nimalie Rodrigo, MDNPI 1558649681

Title

Owner of Entity

Phone

(732) 835-2209

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nimalie Rodrigo, M.D.

  • Obstetrics & Gynecology Physician
  • Freehold, NJ
  • NPI 1558649681
  NPD Authorized official

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716681600000",
    "number": "1548024698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 US HIGHWAY 9 UNIT 4",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283285",
            "telephone_number": "732-835-2209",
            "fax_number": "848-444-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 US HIGHWAY 9 UNIT 4",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283285",
            "telephone_number": "732-835-2209",
            "fax_number": "848-444-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE MEDICAL AESTHETICS AND WELLNESS SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-05-26",
        "certification_date": "2024-05-26",
        "status": "A",
        "authorized_official_last_name": "RODRIGO",
        "authorized_official_first_name": "NIMALIE",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "732-835-2209",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Rene-Oster, RN
• Michelle Reslier, PA
• Alyson Resnick, MA, LMHC, LPC, ACS
• Resolution Care Corporation
• Nestor Serrano Restua, MD
• Adrian L Reyes, P.T.
• Stefanie Reynolds, FNP-C
• Alisa Reznikov, MD
• Rgohel LLC
• Rhythm Medical Transportation

• Obstetrics & Gynecology Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2024; 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.