Organization
MD HEALTHCARE SERVICES-NJ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OLGA GOLFINOPOULOS CEO (CEO)
20124255488
Entity
Organization
Contact information
Practice address
1512 12TH ST, FORT LEE, NJ 07024-2126
(201) 280-4640
(201) 242-5548
Mailing address
1512 12TH ST, FORT LEE, NJ 07024-2126
(201) 280-4640
(201) 242-5548
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0400517081
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400517081
CERTIFICATE OF FORMATION NUMBER
NJ
Enumeration date
03/19/2014
Last updated
03/19/2014
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