Provider Demographics
NPI:1982420261
Name:TSAKU, PEACE
Entity type:Individual
Prefix:
First Name:PEACE
Middle Name:
Last Name:TSAKU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 W SHENENDOAH RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-9024
Mailing Address - Country:US
Mailing Address - Phone:973-337-3253
Mailing Address - Fax:
Practice Address - Street 1:788 SHREWSBURY AVE STE 2221
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3080
Practice Address - Country:US
Practice Address - Phone:732-685-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HP0381100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health