Provider Demographics
NPI:1265860803
Name:DIYA CARE INC
Entity type:Organization
Organization Name:DIYA CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:P
Authorized Official - Last Name:VEDAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-702-3130
Mailing Address - Street 1:1130 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3623
Mailing Address - Country:US
Mailing Address - Phone:848-702-3130
Mailing Address - Fax:
Practice Address - Street 1:1130 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3623
Practice Address - Country:US
Practice Address - Phone:848-702-3130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0180700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid