NPI 1164620803
Tristate Domestic,llc
Practice location
- Address
- 12 Everett St, East Orange, NJ 07017-1740
- Phone
- (973) 678-3030
Authorised official
- Name
- Dominick Iacoviello
- Title
- President
- Phone
- (973) 678-3030
Registered specialties (3)
Private Vehicle
Primary
Home Health Agency
Non-emergency Medical Transport (VAN)
Registry record
- NPI
- 1164620803
- Entity type
- Organization
- NPI issued
- 4 Jul 2007
- Record last updated
- 11 Sep 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.