Organization
ACTIVE AGING MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER KOLESSA MD (PRESIDENT)
(732) 425-3564
Entity
Organization
Contact information
Practice address
244 5TH AVE, SUITE 200, NEW YORK, NY 10001-7604
(732) 425-3564
(888) 999-8689
Mailing address
244 5TH AVE, SUITE 200, NEW YORK, NY 10001-7604
(732) 425-3564
(888) 999-8689
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
254294
NY
Other
Enumeration date
11/19/2014
Last updated
01/21/2015
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