Individual
JILL KATHLEEN MCGOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
106 PROSPECT STREET, 3RD FLOOR, RIDGEWOOD, NJ 07450-4433
(201) 639-2656
Mailing address
510 DEMAREST AVENUE, ORADELL, NJ 07649-1703
(201) 527-7922
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00562300
NJ
Other
Enumeration date
03/07/2020
Last updated
03/07/2020
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