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General NPI Number Information
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NPI Number | 1235722117
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Entity Type | Organization
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Legal Business Name | DYNAMIC CAREGIVERS
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 21 COVERED BRIDGE RD
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City | FLEMINGTON
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State | NJ
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Zip | 08822-4902
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Country | US
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Telephone | 240-476-8875
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Fax |
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Provider Business Mailing Address
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Address Line | 21 COVERED BRIDGE RD
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City | FLEMINGTON
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State | NJ
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Zip | 08822-4902
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Country | US
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Telephone | 908-968-0443
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DOMINIC IKOTIDEM
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Credential |
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Telephone | 301-335-7787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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