Radiant Longevity Care

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RADIANT LONGEVITY CARE

Practice address

140 E Ridgewood Ave
Paramus, NJ 07652-3917

Phone

(201) 989-9777

Fax

(155) 136-1972

NPI assigned

Oct 1, 2025

Organization subpart

No

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

Authorized official

Name

Ralphael Korbla Kukubor

Title

Manager

Phone

(201) 989-9777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1639043755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E RIDGEWOOD AVE STE 415",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523915",
            "telephone_number": "201-989-9777",
            "fax_number": "155-136-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523917",
            "telephone_number": "201-989-9777",
            "fax_number": "155-136-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT LONGEVITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "KUKUBOR",
        "authorized_official_first_name": "RALPHAEL",
        "authorized_official_middle_name": "KORBLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-989-9777"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Paramus, NJ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.