Healthcare Provider Details

I. General information

NPI: 1780512848
Provider Name (Legal Business Name): THE REGENERATIVE SPORTSCARE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 E 88TH ST FL 1
NEW YORK NY
10128-1151
US

IV. Provider business mailing address

62 E 88TH ST FL 1
NEW YORK NY
10128-1151
US

V. Phone/Fax

Practice location:
  • Phone: 646-870-7997
  • Fax: 646-870-7990
Mailing address:
  • Phone: 646-870-7997
  • Fax: 646-870-7990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER SOLOMON
Title or Position: MD
Credential: MD
Phone: 646-870-7997