Provider Demographics
NPI:1457745572
Name:GROVER MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GROVER MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-763-5765
Mailing Address - Street 1:2168 MILLBURN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2640
Mailing Address - Country:US
Mailing Address - Phone:973-763-5765
Mailing Address - Fax:973-763-0505
Practice Address - Street 1:2168 MILLBURN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2640
Practice Address - Country:US
Practice Address - Phone:973-763-5765
Practice Address - Fax:973-763-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty