MEDICARE: LL MEDICAL CLINIC NJ PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1457221830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LL MEDICAL CLINIC NJ PC

Provider Business Mailing Address
First Line	:	316 BERRHILL DR
Second Line	:	ATTN: LL MEDICAL CLINIC NJ P.C.
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3669
Country	:	US
Telephone Number	:	646-877-6366
Fax Number	:	646-655-0480

Provider Business Practice Location Address
First Line	:	316 BERRHILL DR
Second Line	:	ATTN: LL MEDICAL CLINIC NJ P.C.
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3669
Country	:	US
Telephone Number	:	646-877-6366
Fax Number	:	646-655-0480

Authorized Official
Title or Position	:	GC
Name	:	ADI PATEL
Credential	:
Telephone Number	:	646-887-3138

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	02/03/2026

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