LIPOLASER OF SOUTH JERSEY PC
NPI 1205443405
General Practice in Marlton, NJ

Active since September 30, 2020
100 CENTRE BLVD STE 100E, MARLTON, NJ 08053(856) 983-3600 Get Directions Write a Review

NPPES record last updated: September 30, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lipolaser Of South Jersey Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIPOLASER OF SOUTH JERSEY PC (NPI 1205443405), doing business as Revive Life Treatment Center Of South Jersey, is a healthcare organization registered as a general practice in Marlton, New Jersey and active in the NPI registry since September 2020. The organization lists Gregory Pistone, Owner, as its authorized official.

NPPES Registry Identity

NPI1205443405
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLIPOLASER OF SOUTH JERSEY PC
Location Address100 CENTRE BLVD STE 100EMarlton, NJ 08053-4128
Mailing Address100 Centre Blvd Ste 100eMarlton, NJ 08053-4128 · (856) 983-3600
Organization SubpartNo
Authorized OfficialGregory PistoneOwner · (856) 983-3600
Enumeration DateSeptember 30, 2020
NPPES CertifiedSeptember 30, 2020
NPI 1205443405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedDermatologyTaxonomy 207N00000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
100 CENTRE BLVD STE 100E, Marlton, NJ 08053

Other Names 1

Doing Business AsRevive Life Treatment Center Of South Jersey

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
100 CENTRE BLVD STE 100E
MARLTON, NJ 08053

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lipolaser Of South Jersey PC's NPI number?

The NPI number for Lipolaser Of South Jersey PC is 1205443405. It was assigned to this organization in the NPPES registry on September 30, 2020. The provider is doing business as Revive Life Treatment Center of South Jersey.

Where is Lipolaser Of South Jersey PC located?

Lipolaser Of South Jersey PC is located at 100 Centre Blvd Ste 100E, Marlton, NJ 08053. The listed phone number is (856) 983-3600.

What is Lipolaser Of South Jersey PC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Lipolaser Of South Jersey PC was last updated on September 30, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.