Van Dautruche

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

57 Cooper St
Woodbury, NJ 08096-4650

Phone

(856) 384-9433

NPI assigned

Jul 9, 2015

Last updated

Jul 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prestige Support Services

  • Case Management Agency
  • Woodbury, NJ
  • NPI 1215703780
  NPD Authorized official
• Reliable Home Care Services LLC

  • Home Health Registered Nurse
  • Woodbury, NJ
  • NPI 1649506007
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1972986859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 COOPER ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964650",
            "telephone_number": "856-384-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 COOPER ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964650",
            "telephone_number": "856-384-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUTRUCHE",
        "first_name": "VAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crescent Ave Supported Living
• Stephanie Cypreste
• Dale Stein and Associates, O.D.,P.C.
• Rasheeda Nichole Dale, LSW
• Nicholas R. Dalsey, D.O.
• David D Carrozzino DPM, PC
• David Gehring M.D.
• Stanley David, D.P.M.
• Wendy Faith David, DPM
• Eddie Benjamin Davis III

• Case Manager/Care Coordinator in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Case Manager/Care Coordinator in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.