Provider Demographics
NPI:1265544787
Name:ACCLAIM THERAPEUTICS, LLC
Entity type:Organization
Organization Name:ACCLAIM THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-303-2363
Mailing Address - Street 1:1100 TAYLORS LN
Mailing Address - Street 2:UNIT #9
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2586
Mailing Address - Country:US
Mailing Address - Phone:856-303-2363
Mailing Address - Fax:856-303-0645
Practice Address - Street 1:1100 TAYLORS LN
Practice Address - Street 2:UNIT #9
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2586
Practice Address - Country:US
Practice Address - Phone:856-303-2363
Practice Address - Fax:856-303-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0600-1682-94332B00000X
NJ0600-1680-94332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0060348Medicaid
NJ0060348Medicaid