Provider Demographics
NPI:1982468880
Name:REJUVEN8 HYDRATION & AESTHETICS
Entity Type:Organization
Organization Name:REJUVEN8 HYDRATION & AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG-MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-857-7375
Mailing Address - Street 1:2230 ROUTE 70 W
Mailing Address - Street 2:SUITE 2, #1188
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002
Mailing Address - Country:US
Mailing Address - Phone:856-857-7375
Mailing Address - Fax:
Practice Address - Street 1:1036 OWL LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2923
Practice Address - Country:US
Practice Address - Phone:856-857-7375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty