Organization
COLTS NECK ANTI-AGING MED CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M. GOLDING- GRANADO MD (OWNER)
(201) 232-6887
Entity
Organization
Contact information
Practice address
178 ROUTE 537, COLTS NECK, NJ 07722-1678
(732) 431-8000
Mailing address
178 ROUTE 537, COLTS NECK, NJ 07722-1678
(732) 431-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
08/08/2023
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