Healthcare Provider Details

I. General information

NPI: 1053280107
Provider Name (Legal Business Name): STARHEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 WAKEMAN AVE # APRT2
NEWARK NJ
07104-3031
US

IV. Provider business mailing address

138 WAKEMAN AVE # APRT2
NEWARK NJ
07104-3031
US

V. Phone/Fax

Practice location:
  • Phone: 973-536-7263
  • Fax:
Mailing address:
  • Phone: 973-536-7263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ESTRELLA M. VICENCIO
Title or Position: DIRECTORA
Credential: PCT, EKG HHA
Phone: 973-536-7263