# MOBILE HEALTH CARE FAMILY CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205662228
- **Authorized official:** FONDERRE L MUSONGONG FNP (MANAGER)
- **Authorized official phone:** (845) 290-7287

## Contact information

- **Practice address:** 19-21 FAIR LAWN AVE STE 2C, FAIR LAWN, NJ 07410-2337
- **Practice address phone:** (201) 479-4596
- **Practice address fax:** (201) 499-7938
- **Mailing address:** 10 WALNUT WAY, HIGHLAND MILLS, NY 10930-2810
- **Mailing address phone:** (845) 290-7287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2024
- **Last updated:** 06/16/2025