Healthcare Provider Details

I. General information

NPI: 1558839399
Provider Name (Legal Business Name): PROACTIVE HEALTH INFUSIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CRAIG RD. STE.102
MANALAPAN NJ
07726-8742
US

IV. Provider business mailing address

300 CRAIG RD. STE.102
MANALAPAN NJ
07726-8742
US

V. Phone/Fax

Practice location:
  • Phone: 732-780-8671
  • Fax: 732-845-1344
Mailing address:
  • Phone: 732-780-8671
  • Fax: 732-845-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH NAPPI
Title or Position: DIRECTOR
Credential: DC
Phone: 732-780-8671