Provider Demographics
NPI:1851632988
Name:SAJONIA D'LIGHT SPA
Entity Type:Organization
Organization Name:SAJONIA D'LIGHT SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRISCHEISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-428-1550
Mailing Address - Street 1:856 KEARNY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07032
Mailing Address - Country:US
Mailing Address - Phone:201-428-1550
Mailing Address - Fax:
Practice Address - Street 1:856 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3211
Practice Address - Country:US
Practice Address - Phone:201-428-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00406800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty