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General NPI Number Information
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NPI Number | 1376006486
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Entity Type | Organization
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Legal Business Name | MGV MEDICAL, LLC
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 48 S FRANKLIN TPKE STE 104
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City | RAMSEY
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State | NJ
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Zip | 07446-2558
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Country | US
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Telephone | 201-962-9199
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Fax |
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Provider Business Mailing Address
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Address Line | 48 S FRANKLIN TPKE STE 104
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City | RAMSEY
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State | NJ
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Zip | 07446-2558
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Country | US
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Telephone | 201-962-9199
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KEVIN MCELROY
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Credential | DO
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Telephone | 201-962-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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