Provider Demographics
NPI:1558976670
Name:NYC REGENERATIVE MEDICINE
Entity Type:Organization
Organization Name:NYC REGENERATIVE MEDICINE
Other - Org Name:COLTS NECK STEM CELLS & REGENERATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-867-7330
Mailing Address - Street 1:17 SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4302
Mailing Address - Country:US
Mailing Address - Phone:732-867-7330
Mailing Address - Fax:
Practice Address - Street 1:315 ROUTE 34 STE 103
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2444
Practice Address - Country:US
Practice Address - Phone:732-867-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty