Northeast Institute for Age Management

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

NORTHEAST INSTITUTE FOR AGE MANAGEMENT

Doing business as

Rejuvenesssence Age Management

Practice address

401 New Rd Ste 103
Linwood, NJ 08221-1200

Phone

(609) 232-7037

NPI assigned

Sep 16, 2021

Last updated

Sep 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Frederick Coville, MDNPI 1679728307

Title

Sole Member

Phone

(609) 232-7037

Specialties & licenses 1

Addresses

Other names 1

• Rejuvenesssence Age Management Doing business as

Locations

Practitioners 3

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.

• Frederick A Coville, MD

  • Plastic and Reconstructive Surgery Physician
  • Linwood, NJ
  • NPI 1679728307

  Plastic Surgery

  NPD Authorized official
• Madison Paige Cooper, PA-C

  • Physician Assistant
  • Lawrence Township, NJ
  • NPI 1962149492
  NPD
• Raymond A. Bernard

  • Certified Registered Nurse Anesthetist
  • Egg Harbor Township, NJ
  • NPI 1093729279
  NPD (past)

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1801566336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NEW RD STE 103",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEW RD STE 103",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211200",
            "telephone_number": "609-232-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INSTITUTE FOR AGE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "COVILLE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "609-232-7037",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rejuvenesssence Age Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• New Perspectives Outpatient Services LLC
• Nicolapt LLC (Cape Atlantic Physical Therapy)
• Nik Parikh MD PA
• NJ Internal Medicine Associates LLC
• Norman Chazin MD LLC
• Brian O'Shea
• Oaks Integrated Care, Inc
• Andrea Lynn Olsen, PT, DPT
• Orozco Orthopaedics LLC
• Fabio Ramiro Orozco, M.D.

• Plastic Surgery Physician in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.