Healthcare Provider Details

I. General information

NPI: 1871141119
Provider Name (Legal Business Name): NASPAC-NJ PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 THOMAS JONES WAY STE 304
EXTON PA
19341-2553
US

IV. Provider business mailing address

404 CREEK CROSSING BLVD STE 404
HAINESPORT NJ
08036-2768
US

V. Phone/Fax

Practice location:
  • Phone: 484-879-6508
  • Fax: 484-879-6509
Mailing address:
  • Phone: 609-845-3988
  • Fax: 609-288-6078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SANJAY CHEULKAR
Title or Position: COO
Credential:
Phone: 609-410-9424