Longevity Clinical Ltc Associates of New Jersey
NPI 1376114322ActiveOrganization· Nurse Practitioner, Primary Care· Lakewood, NJ
Nurse Practitioner, Primary Care in Lakewood, New Jersey, registered in NPPES in July 2021. The authorized official on file is Diane Vincur, Clinical Support Talent Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376114322 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 9, 2021 |
| Last updated in NPPES | Jul 9, 2021 |
| Certified by provider | Jul 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Family Medicine, Geriatric Medicine | 207QG0300X | — | — |
| Nurse Practitioner, Gerontology | 363LG0600X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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