Organization
JERSEY SHORE REJUVINATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIELE P JASPER MD (MANAGING MEMBER)
(732) 262-2809
Entity
Organization
Contact information
Practice address
74 BRICK BLVD STE 124, BRICK, NJ 08723-7984
(732) 262-2809
(732) 262-0400
Mailing address
74 BRICK BLVD STE 124, BRICK, NJ 08723-7984
(732) 262-2809
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MA06352100
NJ
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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