Healthcare Provider Details

I. General information

NPI: 1295647956
Provider Name (Legal Business Name): I LASERED IT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 HARBORTOWN BLVD
PERTH AMBOY NJ
08861-2972
US

IV. Provider business mailing address

834 HARBORTOWN BLVD
PERTH AMBOY NJ
08861-2972
US

V. Phone/Fax

Practice location:
  • Phone: 512-842-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BROWN
Title or Position: MANAGER
Credential:
Phone: 512-842-0500