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CLOVER HOME CARE
NPI 1972044923
Internal Medicine - Geriatric Medicine in Lyndhurst, NJ

Active since March 10, 2017CLIA Certified · 2 labs
125 CHUBB AVE, SUITE 100-S, LYNDHURST, NJ 07071(201) 559-7600 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2022, Sep 28, 2022, Apr 21, 2017 (3 updates tracked since 2017).

About Clover Home Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLOVER HOME CARE (NPI 1972044923) is a healthcare organization registered as a geriatric medicine in Lyndhurst, New Jersey and active in the NPI registry since March 2017. The organization holds 2 active CLIA laboratory certificates and lists Kelly Fontana, Director Of Clinical Compliance, as its authorized official.

NPPES Registry Identity

NPI1972044923
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameMEDICAL SERVICE PROFESSIONALS OF NJ LLC
Location Address125 CHUBB AVE, SUITE 100-SLyndhurst, NJ 07071-3504
Mailing Address125 Chubb Ave Ste 100sLyndhurst, NJ 07071-3504
Phone(201) 559-7600
Organization SubpartNo
Authorized OfficialKelly FontanaDirector Of Clinical Compliance · (631) 457-9145
Enumeration DateMarch 10, 2017
Last NPPES UpdateOctober 12, 20223 updates tracked since enumeration
NPPES CertifiedOctober 12, 2022
✔ NPI 1972044923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
Also ListedFamily Medicine · Hospice and Palliative MedicineTaxonomy 207QH0002X
Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X
125 CHUBB AVE, Lyndhurst, NJ 07071
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Other Names 1

Doing Business AsClover Home Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2136414

Medical Service Professionals Of Nj, LLC · Lyndhurst, NJ
Active · expires Dec 13, 2027
CLIA Number31D2136414
Laboratory TypePhysician Office
Certificate Effective DateDecember 14, 2025
Certificate Expiration DateDecember 13, 2027
Laboratory DirectorGonzalo Olivares Maldonado
Laboratory Phone(631) 457-9145
Laboratory LocationMedical Service Professionals Of Nj, LLC125 Chubb Ave Suite 100, Lyndhurst, NJ 07071
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2319168

Medical Service Professionals Of Nj, LLC · Macon, GA
Active · expires Feb 24, 2027
CLIA Number11D2319168
Laboratory TypePhysician Office
Certificate Effective DateFebruary 25, 2025
Certificate Expiration DateFebruary 24, 2027
Laboratory DirectorGonzalo Olivares Maldonado
Laboratory Phone(631) 457-9145
Laboratory LocationMedical Service Professionals Of Nj, LLC1760 Bass Road, Suite 200A, Macon, GA 31210
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE SCULLY LCSW
Social Worker (Clinical)
125 CHUBB AVE
LYNDHURST, NJ 07071
Bergen County (201) 559-7600
MELISSA SUE EVANS APN-C
Nurse Practitioner (Primary Care)
125 CHUBB AVE
LYNDHURST, NJ 07071
Bergen County (201) 559-7600
TASHIA WILLIAMS DNP
Nurse Practitioner (Adult Health)
125 CHUBB AVE
LYNDHURST, NJ 07071
Bergen County (201) 559-7600
CHRISTINA SOON HEO AGNP-C
Nurse Practitioner (Adult Health)
125 CHUBB AVE
LYNDHURST, NJ 07071
Bergen County (201) 559-7600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medical Service Professionals Of Nj LLC's NPI number?

The NPI number for Medical Service Professionals Of Nj LLC is 1972044923. It was assigned to this organization in the NPPES registry on March 10, 2017. The provider is doing business as Clover Home Care.

Where is Medical Service Professionals Of Nj LLC located?

Medical Service Professionals Of Nj LLC is located at 125 Chubb Ave Suite 100-S, Lyndhurst, NJ 07071. The listed phone number is (201) 559-7600.

What is Medical Service Professionals Of Nj LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Does Medical Service Professionals Of Nj LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Medical Service Professionals Of Nj LLC was last updated on October 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.