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

Geriatrics and Longevity Treatment Specialist, PC

Organization Geriatric Medicine (Family Medicine) Physician · NPI 1306121504

Geriatrics and Longevity Treatment Specialist, PC is a Geriatric Medicine (Family Medicine) Physician in Hackensack, New Jersey. Registered with an NPI since 2011.

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

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Practice location Address checks out

810 Main St
Hackensack, NJ 07601-4847
Phone: (201) 663-7375
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Family Medicine) Physician (primary) Taxonomy 207QG0300X

Record details

NPI number1306121504
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stefanos Pantagis — Owner · (201) 663-7375
NPI enumeratedOctober 19, 2011
Last updated in NPPESNovember 13, 2013
Mailing address810 Main St, Hackensack, NJ 07601-4847

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