Organization
REJUVENATION MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CANDELARIO MD (OWNER)
(201) 962-3878
Entity
Organization
Contact information
Practice address
830 GARRISON AVE, TEANECK, NJ 07666-2542
(201) 785-7997
(201) 962-3878
Mailing address
19 PARSONS CT, MAHWAH, NJ 07430-2018
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
25MA09608700
NJ
Other
Enumeration date
06/22/2017
Last updated
07/11/2017
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