Provider Demographics
NPI:1447816913
Name:PROJECT DART LLC
Entity type:Organization
Organization Name:PROJECT DART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THAMESHWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHABIR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-342-1338
Mailing Address - Street 1:1041 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-1716
Mailing Address - Country:US
Mailing Address - Phone:973-957-9755
Mailing Address - Fax:973-957-0756
Practice Address - Street 1:1041 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-1716
Practice Address - Country:US
Practice Address - Phone:973-957-9755
Practice Address - Fax:973-957-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health