# LONGEVITY WELLNESS PA

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

## Provider details

- **NPI number:** 1477146058
- **Authorized official:** DR. STEPHEN J CONTE DO (PRESIDENT)
- **Authorized official phone:** (201) 291-1616

## Contact information

- **Practice address:** 251 ROCHELLE AVE, ROCHELLE PARK, NJ 07662-3914
- **Practice address phone:** (201) 291-1616
- **Practice address fax:** (201) 291-1619
- **Mailing address:** 201 W PASSAIC ST STE 301, ROCHELLE PARK, NJ 07662-3126
- **Mailing address phone:** (201) 291-1616
- **Mailing address fax:** (201) 291-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |

## Other

- **Enumeration date:** 02/16/2021
- **Last updated:** 02/16/2021