Renew Med Spa and Clinic LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

RENEW MED SPA AND CLINIC LLC

Practice address

601 Hamburg Tpke Ste 101
Wayne, NJ 07470-2049

Phone

(973) 942-4449

Fax

(973) 942-6339

NPI assigned

Aug 23, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer M Matier, MD

Title

Owner

Phone

(973) 809-4186

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1780165100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BAKER ST",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HAMBURG TPKE STE 101",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702049",
            "telephone_number": "973-942-4449",
            "fax_number": "973-942-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW MED SPA AND CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "MATIER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-809-4186",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.