Healthcare Provider Details

I. General information

NPI: 1598628679
Provider Name (Legal Business Name): ADOM HEALTHCARE AND STAFFING AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1478 PARKSIDE AVE
EWING NJ
08638-2936
US

IV. Provider business mailing address

1478 PARKSIDE AVE
EWING NJ
08638-2936
US

V. Phone/Fax

Practice location:
  • Phone: 609-847-4190
  • Fax:
Mailing address:
  • Phone: 609-847-4190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ELLIIOT AZU
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 609-847-4190