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Organization
ROOSEVELT CARE OF CALIFORNIA PC
Active
Organization
ROOSEVELT CARE OF CALIFORNIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOV NEWMARK (CEO)
(732) 567-3438
Entity
Organization
Contact information
Practice address
826 N MARIPOSA AVE, LOS ANGELES, CA 90029-3405
(848) 210-4422
Mailing address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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