Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Active Aging Medical Group Inc

Organization Medical Specialty Clinic/Center · NPI 1720368772

Active Aging Medical Group Inc is a Medical Specialty Clinic/Center in Newark, New Jersey. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

188 Jefferson St Suite# 111
Newark, NJ 07105-1622
Phone: (732) 425-3564
Fax: (212) 238-7760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X

Record details

NPI number1720368772
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alexander Kolessa — Chief Medical Officer · (732) 425-3564
NPI enumeratedAugust 23, 2011
Last updated in NPPESAugust 23, 2011
Mailing address188 Jefferson St, Suite# 111, Newark, NJ 07105-1622

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