Healthcare Provider Details

I. General information

NPI: 1104747856
Provider Name (Legal Business Name): JERSEY CONSTRUCTION BUSINESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 FINLAY PL
NEWARK NJ
07106-1017
US

IV. Provider business mailing address

31 FINLAY PL
NEWARK NJ
07106-1017
US

V. Phone/Fax

Practice location:
  • Phone: 973-382-6054
  • Fax:
Mailing address:
  • Phone: 973-382-6054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDUL AAKHIR YASIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 973-382-6054