Healthcare Provider Details

I. General information

NPI: 1699578856
Provider Name (Legal Business Name): JE MEDICINE & AESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 PARKVIEW DR
ROSELLE NJ
07203-3093
US

IV. Provider business mailing address

2415 PARKVIEW DR
ROSELLE NJ
07203-3093
US

V. Phone/Fax

Practice location:
  • Phone: 856-745-5758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON RABINOWITZ
Title or Position: OWNER
Credential: DPM
Phone: 856-745-5758