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General NPI Number Information
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NPI Number | 1588527303
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Entity Type | Organization
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Legal Business Name | KEYSTONE GERIATRIC SPECIALISTS OF NEW JERSEY
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 255 W SPRING VALLEY AVE STE 200A
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City | MAYWOOD
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State | NJ
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Zip | 07607-1444
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Country | US
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Telephone | 201-447-3690
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Fax |
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Provider Business Mailing Address
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Address Line | 3036 HIGHWAY 35 # 278
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City | HAZLET
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State | NJ
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Zip | 07730-1505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | ARIADNE PANAGIOTOU
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Credential |
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Telephone | 201-447-3690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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