=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962870428
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DCI PROPERTY MAINTENANCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2015
-----------------------------------------------------
Last Update Date | 09/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 280 RIDGE RD
-----------------------------------------------------
City | FRENCHTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08825-4107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-996-3888
-----------------------------------------------------
Fax | 908-996-3610
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 280 RIDGE RD
-----------------------------------------------------
City | FRENCHTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08825-4107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-996-3888
-----------------------------------------------------
Fax | 908-996-3610
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT/SECRETARY
-----------------------------------------------------
Name | MR. ANTHONY DESAPIO JR.
-----------------------------------------------------
Credential | GENERAL CONTRACTOR
-----------------------------------------------------
Telephone | 908-996-3888
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171W00000X
-----------------------------------------------------
Taxonomy Name | Contractor
-----------------------------------------------------
License Number | 67230
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------