Rejuveinate LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

REJUVEINATE LLC

Practice address

1 N Washington Ave
Bergenfield, NJ 07621-2125

Phone

(443) 414-8201

NPI assigned

Jun 27, 2019

Organization subpart

No

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

Authorized official

Name

Abraham R Lehman, MD

Title

Authorized Representative

Phone

(718) 222-5999

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1952962169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 HEIGHTS RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121215",
            "telephone_number": "443-414-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212125",
            "telephone_number": "443-414-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVEINATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "LEHMAN",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "718-222-5999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.