Healthcare Provider Details

I. General information

NPI: 1073479010
Provider Name (Legal Business Name): AXARA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 TUXEDO DR
WAYNE NJ
07470-2728
US

IV. Provider business mailing address

38 TUXEDO DR
WAYNE NJ
07470-2728
US

V. Phone/Fax

Practice location:
  • Phone: 973-320-7020
  • Fax: 862-300-3960
Mailing address:
  • Phone: 973-320-7020
  • Fax: 862-300-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEANNA SANACORE
Title or Position: MANAGING MEMBER
Credential: NP
Phone: 862-591-0454