# RENEW MED SPA AND CLINIC LLC

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

## Provider details

- **NPI number:** 1780165100
- **Authorized official:** JENNIFER M MATIER MD (OWNER)
- **Authorized official phone:** (973) 809-4186

## Contact information

- **Practice address:** 601 HAMBURG TPKE STE 101, WAYNE, NJ 07470-2049
- **Practice address phone:** (973) 942-4449
- **Practice address fax:** (973) 942-6339
- **Mailing address:** 3 BAKER ST, WAYNE, NJ 07470-4601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/23/2018
- **Last updated:** 08/23/2018