Individual
KAYLA MICHELLE MCGOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
106 PROSPECT ST, RIDGEWOOD, NJ 07450-4433
(201) 639-2656
(201) 345-4405
Mailing address
510 DEMAREST AVE, ORADELL, NJ 07649-1703
(201) 835-9083
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00738900
NJ
Other
Enumeration date
09/29/2022
Last updated
09/30/2022
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