Healthcare Provider Details

I. General information

NPI: 1093902900
Provider Name (Legal Business Name): DAO SHENG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 WILLOW AVE
HOBOKEN NJ
07030-7909
US

IV. Provider business mailing address

217 WILLOW AVE
HOBOKEN NJ
07030-7909
US

V. Phone/Fax

Practice location:
  • Phone: 201-659-0100
  • Fax:
Mailing address:
  • Phone: 201-659-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberP0084
License Number StateNJ

VIII. Authorized Official

Name: TERESA LOH
Title or Position: OFFICE MANAGER
Credential:
Phone: 201-659-0100