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General NPI Number Information
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NPI Number | 1043173800
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Entity Type | Organization
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Legal Business Name | HOUSE CALL MEDICAL SERVICES OF NEW JERSEY
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 28 VALLEY RD # 229
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2709
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Country | US
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Telephone | 718-561-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 HALPERIN AVE FL 1
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City | BRONX
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State | NY
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Zip | 10461-2631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERVIN MORTAZAVI
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Credential | MD
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Telephone | 646-350-1619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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