Healthcare Provider Details

I. General information

NPI: 1215474218
Provider Name (Legal Business Name): DAAZE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 POPLAR PL
PISCATAWAY NJ
08854-1731
US

IV. Provider business mailing address

207 POPLAR PL
PISCATAWAY NJ
08854-1731
US

V. Phone/Fax

Practice location:
  • Phone: 908-294-2450
  • Fax:
Mailing address:
  • Phone: 908-294-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. FELIX TSAMEZEU
Title or Position: RESPONSIBLE PARTY
Credential:
Phone: 908-294-2450