Healthcare Provider Details

I. General information

NPI: 1992827109
Provider Name (Legal Business Name): DAAK OF NJ, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 KAPKOWSKI RD
ELIZABETH NJ
07201-4901
US

IV. Provider business mailing address

651 KAPKOWSKI RD
ELIZABETH NJ
07201-4901
US

V. Phone/Fax

Practice location:
  • Phone: 908-354-1599
  • Fax: 908-354-1344
Mailing address:
  • Phone: 908-354-1599
  • Fax: 908-354-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTU004834-1
License Number StateNY

VIII. Authorized Official

Name: MRS. CHRISTINE URREGO
Title or Position: OWNER
Credential:
Phone: 908-354-1599