Healthcare Provider Details

I. General information

NPI: 1427602549
Provider Name (Legal Business Name): EXCELLENT HOMECARE OF NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 GALESI DR STE 5B
WAYNE NJ
07470-4841
US

IV. Provider business mailing address

1 GRANDVIEW TER
RAMSEY NJ
07446-1636
US

V. Phone/Fax

Practice location:
  • Phone: 973-931-0797
  • Fax:
Mailing address:
  • Phone: 973-931-0797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. GERALDINE SANCHEZ-MARAPAO
Title or Position: MANAGER
Credential: PT
Phone: 973-931-0797