Provider Demographics
NPI:1114659950
Name:VAVA CONSULTING SERVICES
Entity Type:Organization
Organization Name:VAVA CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRISANI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MAOB, CCS, LCADC
Authorized Official - Phone:973-636-8110
Mailing Address - Street 1:32 RICHARD SCOTT COURT
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508
Mailing Address - Country:US
Mailing Address - Phone:973-636-8110
Mailing Address - Fax:
Practice Address - Street 1:32 RICHARD SCOTT COURT
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-0750
Practice Address - Country:US
Practice Address - Phone:973-636-8110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service