NPI 1629707369 · live from the CMS NPI Registry
Active Health Marmora LLC
Family Medicine in Marmora, NJ. National Provider Identifier 1629707369, active.
NPI record
| NPI | 1629707369 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 16 Roosevelt Blvd, Marmora, NJ 08223 |
| Practice phone | 609-886-8585 |
| Mailing address | 1501 Route 47, Rio Grande, NJ 08242 |
| Enumerated | June 8, 2022 |
| Last updated | June 8, 2022 |
| Authorized official | Robert Olivieri, Authorized Official |
| Other names | Active Joint And Spine Institute |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor | 111N00000X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.