Provider Demographics
NPI:1093581902
Name:STEM-REGEN MEDICAL WELLNESS & REHABILITATION PC
Entity Type:Organization
Organization Name:STEM-REGEN MEDICAL WELLNESS & REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOALEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-368-2222
Mailing Address - Street 1:PO BOX 234696
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-4696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:66 N RTE 17 STE 150
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2742
Practice Address - Country:US
Practice Address - Phone:201-368-2222
Practice Address - Fax:201-368-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty