Provider Demographics
NPI:1710603410
Name:DANEXA LLC
Entity Type:Organization
Organization Name:DANEXA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HILL-PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:908-494-3055
Mailing Address - Street 1:50 E LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1409
Mailing Address - Country:US
Mailing Address - Phone:908-494-3055
Mailing Address - Fax:
Practice Address - Street 1:12 KROTIK PL
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1708
Practice Address - Country:US
Practice Address - Phone:908-494-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization