Provider Demographics
NPI:1801225537
Name:DC HEALTH CARE LLC
Entity Type:Organization
Organization Name:DC HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DEMETRIO
Authorized Official - Last Name:DSTTEFFANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-489-0728
Mailing Address - Street 1:CHALETS DE LA PLAYA
Mailing Address - Street 2:BLGD 10 APT 170
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:973-489-0728
Mailing Address - Fax:
Practice Address - Street 1:CHALETS DE LA PLAYA
Practice Address - Street 2:BLGD 10 APT 170
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:973-489-0728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18562208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty