Jersey Coast Vein and Laser Center LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA49373 Issued in NJ

Legal business name

JERSEY COAST VEIN AND LASER CENTER LLC

Practice address

1608 Route 88 West
Suite 207
Brick, NJ 08724

Phone

(732) 202-1500

Fax

(732) 202-1058

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Colleen Cosgrove

Title

Office Manager

Phone

(732) 202-1500

Specialties & licenses 1

Addresses

Practitioners 1

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

• Rainier Aquino, MD

  • Specialist
  • Brick, NJ
  • NPI 1396718862
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861428336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 ROUTE 88 WEST",
            "address_2": "SUITE 207",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-202-1500",
            "fax_number": "732-202-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 ROUTE 88 WEST",
            "address_2": "SUITE 207",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-202-1500",
            "fax_number": "732-202-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY COAST VEIN AND LASER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSGROVE",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-202-1500"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA49373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Jerome, M.A.CCC-SLP
• Jersey Coast Family Medicine LLC
• Jersey Coast Family Medicine LLC
• Jersey Coast Nephrology and Hypertension Associates LLC
• Jersey Coast Vascular Associates PA
• Jersey Shore Eyecare
• Jersey Shore Rejuvination Center, LLC
• Jersey Shore Speech Therapy LLC
• Jersey Shore Therapies
• Samir C. Jethwa, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.