| Activelife Regenerative Therapies | |
|
413 Wanaque Ave Pompton Lakes NJ 07442-1844 | |
| (973) 997-0542 | |
| (973) 831-6763 |
| Full Name | Activelife Regenerative Therapies |
|---|---|
| Speciality | Internal Medicine |
| Location | 413 Wanaque Ave, Pompton Lakes, New Jersey |
| Authorized Official Name and Position | Kenneth Wolosz (OWNER) |
| Authorized Official Contact | 9739970542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Activelife Regenerative Therapies 413 Wanaque Ave Pompton Lakes NJ 07442-1844 Ph: (973) 997-0542 | Activelife Regenerative Therapies 413 Wanaque Ave Pompton Lakes NJ 07442-1844 Ph: (973) 997-0542 |
| NPI Number | 1225708886 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 01/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225708886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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