Healthcare Provider Details

I. General information

NPI: 1407655681
Provider Name (Legal Business Name): DAY STAKE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18-01 POLLITT DR
FAIR LAWN NJ
07410-2813
US

IV. Provider business mailing address

19 ORCHARD PL
HAWTHORNE NJ
07506-3123
US

V. Phone/Fax

Practice location:
  • Phone: 201-242-0305
  • Fax:
Mailing address:
  • Phone: 201-242-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TUCCI
Title or Position: PRESIDENT
Credential:
Phone: 201-242-0305