# NEW LIFESTYLE MEDICAL PA

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

## Provider details

- **NPI number:** 1134563802
- **Authorized official:** IGOR GEFTER M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (201) 468-8808

## Contact information

- **Practice address:** 19-21 FAIR LAWN AVE, STE 2E, FAIR LAWN, NJ 07410-2331
- **Practice address phone:** (201) 468-8808
- **Practice address fax:** (201) 815-2520
- **Mailing address:** 19-21 FAIR LAWN AVE, STE 2E, FAIR LAWN, NJ 07410-2331
- **Mailing address phone:** (201) 468-8808
- **Mailing address fax:** (201) 815-2520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 25MA06438600 | NJ | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 25MA06438600 | NJ | — |
| 207QA0505X | Adult Medicine Physician | 25MA06438600 | NJ | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | 25MA06438600 | NJ | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 25MA05661500 | NJ | Yes |
| 2084P0005X | Neurodevelopmental Disabilities Physician | 25MA05661500 | NJ | — |
| 2084P0015X | Psychosomatic Medicine Physician | 25MA05661500 | NJ | — |
| 2084P0800X | Psychiatry Physician | 25MA05661500 | NJ | — |
| 2084P0802X | Addiction Psychiatry Physician | 25MA05661500 | NJ | — |

## Other

- **Enumeration date:** 04/24/2013
- **Last updated:** 01/09/2015