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General NPI Number Information
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NPI Number | 1073479010
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Entity Type | Organization
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Legal Business Name | AXARA HEALTH
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Dates
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Enumeration Date | 01/03/2026
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 38 TUXEDO DR
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City | WAYNE
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State | NJ
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Zip | 07470-2728
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Country | US
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Telephone | 973-320-7020
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Fax | 862-300-3960
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Provider Business Mailing Address
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Address Line | 38 TUXEDO DR
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City | WAYNE
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State | NJ
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Zip | 07470-2728
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Country | US
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Telephone | 973-320-7020
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Fax | 862-300-3960
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DEANNA SANACORE
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Credential | NP
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Telephone | 862-591-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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