Provider Demographics
NPI:1922481423
Name:LONGEVITY SURGICAL LLC.
Entity Type:Organization
Organization Name:LONGEVITY SURGICAL LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWECHTER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CFOM
Authorized Official - Phone:201-567-5088
Mailing Address - Street 1:25 S VAN BRUNT ST STE E
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3498
Mailing Address - Country:US
Mailing Address - Phone:201-569-8033
Mailing Address - Fax:
Practice Address - Street 1:25 S VAN BRUNT ST STE E
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3498
Practice Address - Country:US
Practice Address - Phone:201-569-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier