Organization
CEDAR GROVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROTH RILEY MD (PHYSICIAN)
(973) 742-6260
Entity
Organization
Contact information
Practice address
870 POMPTON AVE, CEDAR GROVE, NJ 07009-1203
(973) 433-0889
Mailing address
870 POMPTON AVE, CEDAR GROVE, NJ 07009-1203
(973) 433-0889
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831241264
NPI
NJ
Enumeration date
09/13/2022
Last updated
09/16/2022
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