NPIMap

Organization Active NPI

Genesis Integrative Medicine Longevity Center LLC

  • Community/Behavioral Health Agency
  • Lake Como, NJ
National Provider Identifier
1578299558
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GENESIS INTEGRATIVE MEDICINE LONGEVITY CENTER LLC
Practice address
1716 Main St
Lake Como, NJ 07719-3052
Phone
(732) 681-1000
Fax
(732) 681-1004
NPI assigned
Aug 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Dr. Joseph Louro, DCNPI 1881688984
Title
Chiropractor
Phone
(732) 681-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1716 Main St
Lake Como, NJ 07719-3052

Mailing address

1716 Main St
Lake Como, NJ 07719-3052
Phone (732) 681-1000

National Provider Directory

National Provider Directory

Locations

1716 Main St
Lake Como, NJ 07719
Phone (732) 681-1000

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": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1578299558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193052",
            "telephone_number": "732-681-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193052",
            "telephone_number": "732-681-1000",
            "fax_number": "732-681-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS INTEGRATIVE MEDICINE LONGEVITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-11-04",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "LOURO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "732-681-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Como, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.