Organization Name: | JOUVENCE LLC |
NPI Number: | 1003236589 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LODZE STECKMAN (OWNER) |
Mailing Address: | 277 Piping Rock Rd Locust Valley |
State: | NY US |
Postal Code: | 115602504 |
Phone Number: | 7812543091 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2014 |
NPI Last Update Date: | 04/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 256450 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |