Provider Demographics
NPI:1497258909
Name:HONESTUS RNFA LLC
Entity Type:Organization
Organization Name:HONESTUS RNFA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE FIRST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:FENGYU
Authorized Official - Middle Name:
Authorized Official - Last Name:JIANG
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:973-637-0862
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:MOUNT FREEDOM
Mailing Address - State:NJ
Mailing Address - Zip Code:07970-0342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 ROLLING RIDGE RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4533
Practice Address - Country:US
Practice Address - Phone:973-876-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-10
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11389500163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty