Organization
MEDICAL SERVICE PROFESSIONALS OF NJ LLC
Active
Other names
Clover Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY FONTANA (DIRECTOR OF CLINICAL COMPLIANCE)
(631) 457-9145
Entity
Organization
Contact information
Practice address
125 CHUBB AVE, SUITE 100-S, LYNDHURST, NJ 07071-3504
(201) 559-7600
Mailing address
125 CHUBB AVE STE 100S, LYNDHURST, NJ 07071-3504
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
03/10/2017
Last updated
10/12/2022
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