Rejuvenation Medicine LLC

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

25MA09608700 Issued in NJ

Legal business name

REJUVENATION MEDICINE LLC

Practice address

830 Garrison Ave
Teaneck, NJ 07666-2542

Phone

(201) 785-7997

Fax

(201) 962-3878

NPI assigned

Jun 22, 2017

Organization subpart

No

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

Authorized official

Name

Grace Candelario, MDNPI 1144253725

Title

Owner

Phone

(201) 962-3878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Grace S Candelario, MD

  • Hospitalist Physician
  • Newark, NY
  • NPI 1144253725

  NJ

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1679093546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PARSONS CT",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074302018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 GARRISON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662542",
            "telephone_number": "201-785-7997",
            "fax_number": "201-962-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "CANDELARIO",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-962-3878",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NJ",
            "license": "25MA09608700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Reidler, PHD
• Toby Reifman, LCSW
• Elizabeth Reiley, MD
• Marianne W. Reilly, RN, MSN, CPNP
• Shoshana Leah Reinhart
• Related Surgical Specialties, PC
• Florence Remes, L.C.S.W.
• Renal Medicine Associates, PA
• Nicole Rengifo
• Alexandra Susan Renzi, M.D.

• Medical Oncology Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Medical Oncology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.