ACTIVE AGING MEDICAL GROUP INC
NPI 1720368772
Clinic/Center - Medical Specialty in Newark, NJ

Q: What is Active Aging Medical Group Inc's NPI number?

The NPI number for Active Aging Medical Group Inc is 1720368772. It was assigned to this organization in the NPPES registry on August 23, 2011.

Q: What is Active Aging Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since August 23, 2011

188 JEFFERSON ST, SUITE# 111, NEWARK, NJ 07105(732) 425-3564(212) 238-7760 Get Directions Write a Review

NPPES record last updated: August 23, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Active Aging Medical Group Inc NPPES

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

ACTIVE AGING MEDICAL GROUP INC (NPI 1720368772) is a healthcare organization registered as a medical specialty in Newark, New Jersey and active in the NPI registry since August 2011. The organization lists Alexander Kolessa, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1720368772

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameACTIVE AGING MEDICAL GROUP INC

Location Address188 JEFFERSON ST, SUITE# 111Newark, NJ 07105-1622

Mailing Address188 Jefferson St, Suite# 111Newark, NJ 07105-1622 · (732) 425-3564 · Fax (212) 238-7760

Phone(732) 425-3564

Fax(212) 238-7760

Organization SubpartNo

Authorized OfficialAlexander KolessaChief Medical Officer · (732) 425-3564

Enumeration DateAugust 23, 2011

✔ NPI 1720368772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

188 JEFFERSON ST, Newark, NJ 07105

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Other Providers at the Same Location NPPES

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

BILAL ALI SR.

Physical Therapist

188 JEFFERSON ST, SUITE 389
NEWARK, NJ 07105

Essex County (862) 368-7512

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 Active Aging Medical Group Inc's NPI number?

The NPI number for Active Aging Medical Group Inc is 1720368772. It was assigned to this organization in the NPPES registry on August 23, 2011.

Where is Active Aging Medical Group Inc located?

Active Aging Medical Group Inc is located at 188 Jefferson St Suite# 111, Newark, NJ 07105. The listed phone number is (732) 425-3564.

What is Active Aging Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Active Aging Medical Group Inc was last updated on August 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.