Tristate Domestic,llc
NPI #1164620803 in East Orange, New Jersey
Provider Information
- NPI Number
- 1164620803
- Entity Type
- Organization
- Organization Name
- Tristate Domestic,llc
- Primary Specialty
- Private Vehicle
- Enumeration Date
- Jul 4, 2007
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 12 EVERETT ST
- City
- East Orange
- State
- New Jersey
- ZIP Code
- 07017-1740
- Phone
- (973) 678-3030
Authorized Official
- Name
- MR. DOMINICK IACOVIELLO
- Title
- PRESIDENT
- Phone
- (973) 678-3030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
| Non-emergency Medical Transport (VAN) |
| Private Vehicle |
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