# JERSEY SHORE REJUVINATION CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114300225
- **Authorized official:** DR. GABRIELE P JASPER MD (MANAGING MEMBER)
- **Authorized official phone:** (732) 262-2809

## Contact information

- **Practice address:** 74 BRICK BLVD STE 124, BRICK, NJ 08723-7984
- **Practice address phone:** (732) 262-2809
- **Practice address fax:** (732) 262-0400
- **Mailing address:** 74 BRICK BLVD STE 124, BRICK, NJ 08723-7984
- **Mailing address phone:** (732) 262-2809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 25MA06352100 | NJ | Yes |

## Other

- **Enumeration date:** 07/07/2015
- **Last updated:** 07/07/2015