| Cedar Grove Health Llc | |
|
870 Pompton Ave Cedar Grove NJ 07009-1203 | |
| (973) 433-0889 | |
| Not Available |
| Full Name | Cedar Grove Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 870 Pompton Ave, Cedar Grove, New Jersey |
| Authorized Official Name and Position | Roth Riley (PHYSICIAN) |
| Authorized Official Contact | 9737426260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Grove Health Llc 870 Pompton Ave Cedar Grove NJ 07009-1203 Ph: (973) 433-0889 | Cedar Grove Health Llc 870 Pompton Ave Cedar Grove NJ 07009-1203 Ph: (973) 433-0889 |
| NPI Number | 1871215335 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 09/16/2022 |
| Medicare PECOS PAC ID | 6002281748 |
|---|---|
| Medicare Enrollment ID | O20230411000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871215335 | NPI | - | NPPES |
| 1831241264 | Other | NJ | NPI |
| Provider Name | Roth Riley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831241264 PECOS PAC ID: 6608814827 Enrollment ID: I20150521002290 |
| Provider Name | Sahana Boddapati |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194384040 PECOS PAC ID: 3274946173 Enrollment ID: I20210114001610 |
| Provider Name | Cleveland Gajee |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285862276 PECOS PAC ID: 9032584727 Enrollment ID: I20230411002042 |
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