Longevity Medical Group, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA42243 Issued in NJ

Legal business name

LONGEVITY MEDICAL GROUP, P.A.

Practice address

2 Sears Dr
Paramus, NJ 07652-3539

Phone

(201) 265-4647

NPI assigned

Feb 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Roger Howard Coletti, MD

Title

President

Phone

(201) 265-4647

Specialties & licenses 1

Addresses

Other names 1

• Longevity Medical Group, P.A. Former legal business name

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1811229875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8069",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076538069",
            "telephone_number": "201-265-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SEARS DR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523539",
            "telephone_number": "201-265-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "COLETTI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-265-4647",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA42243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longevity Medical Group, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carol Locurcio, LCADC
• Christopher Lollo
• Natalie C Lombardi
• Philip N Lombardo, DPT
• William Donald Long III, M.D.
• Janet Ellen Longo, RD
• Raphael S. Longobardi, M.D.
• Mariola Lopata
• Francesca Lopis, MS, LPC
• Kelly Lopresti, NP

• Specialist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.