Rejuv Aesthetic Gynecology PA

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

25MB09742100 Issued in NJ

Legal business name

REJUV AESTHETIC GYNECOLOGY PA

Practice address

285 Durham Ave Ste 1a
South Plainfield, NJ 07080-2555

Phone

(732) 338-0228

Fax

(201) 485-6792

NPI assigned

Oct 24, 2017

Last updated

Mar 26, 2018By 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

Dr. Edsel Antonio, DO

Title

Provider

Phone

(732) 841-0772

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1841701372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 DURHAM AVE",
            "address_2": "STE 1A BLDG 6",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802546",
            "telephone_number": "732-338-0228",
            "fax_number": "201-485-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 DURHAM AVE STE 1A",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802555",
            "telephone_number": "732-338-0228",
            "fax_number": "201-485-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUV AESTHETIC GYNECOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "ANTONIO",
        "authorized_official_first_name": "EDSEL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "732-841-0772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MB09742100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Younus A. Rakla, MD
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• Emily F Raphel, LCSW
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• Reproductive Center of Central New Jersey
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• Robert Eric Ricaurte
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• David M Richmand, M.D.

• Gynecology Physician in South Plainfield, NJ
• Providers in South Plainfield, NJ by specialty
• Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.