OrganizationActive
Active Aging Medical Group Inc
NPI 1720368772 · Medical Specialty Clinic/Center · Newark, NJ
Provider details
- NPI number
- 1720368772
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Alexander Kolessa, Chief Medical Officer(732) 425-3564
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
188 Jefferson St
Suite# 111
Newark, NJ 07105-1622
Phone: (732) 425-3564
Fax: (212) 238-7760
Approximate (ZIP-level) locationGet directions
Mailing address
188 Jefferson St
Newark, NJ 07105-1622
Registry dates
- Enumerated
- 2011-08-23
- Last updated
- 2011-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.