Living Over 100 Llc | |
104 Route 94 Second Floor Blairstown NJ 07825 | |
(862) 500-1533 | |
(862) 322-6634 |
Full Name | Living Over 100 Llc |
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Speciality | Clinic/center - Primary Care |
Location | 104 Route 94, Blairstown, New Jersey |
Authorized Official Name and Position | Michael Cirone (OWNER) |
Authorized Official Contact | 9733474453 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Living Over 100 Llc 31 Players Blvd Newton NJ 07860-1900 Ph: (973) 347-4453 | Living Over 100 Llc 104 Route 94 Second Floor Blairstown NJ 07825 Ph: (862) 500-1533 |
NPI Number | 1588355705 |
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Provider Enumeration Date | 05/18/2023 |
Last Update Date | 05/18/2023 |
Identifier | Type | State | Issuer |
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1588355705 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |