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TRISTATE DOMESTIC,LLC
NPI 1164620803
Private Vehicle in East Orange, NJ

Active since July 04, 2007
12 EVERETT ST, EAST ORANGE, NJ 07017(973) 678-3030 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Secondary Taxonomies
  4. Authorized Official
  5. Frequently Asked Questions
  • Organization
  • Private Vehicle

About TRISTATE DOMESTIC,LLC

This page provides the complete NPI Profile along with additional information for Tristate Domestic,llc, a provider established in East Orange, New Jersey operating as a Private Vehicle. The healthcare provider is registered in the NPI registry with number 1164620803 assigned on July 2007. The practitioner's primary taxonomy code is 347C00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Dominick Iacoviello (President)

NPI
1164620803 Verify this NPI
Provider Name
TRISTATE DOMESTIC,LLC
Entity Type
Organization
Location Address
12 EVERETT ST EAST ORANGE, NJ 07017
Location Phone
(973) 678-3030
Mailing Address
12 EVERETT ST EAST ORANGE, NJ 07017
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-04-2007
Last Update Date
09-11-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Private Vehicle

Taxonomy Code
347C00000X
Type
Transportation Services
Taxonomy Description
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization		 License No. (State)
1251E00000XAgencies

Home Health

 
2343900000XTransportation Services

Non-emergency Medical Transport (VAN)

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DOMINICK IACOVIELLO

Authorized Official Title
PRESIDENT
Authorized Official Phone
(973) 678-3030

Reviews for TRISTATE DOMESTIC,LLC

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Frequently Asked Questions

What is TRISTATE DOMESTIC,LLC's NPI number?

The NPI number assigned to this healthcare provider is 1164620803, enumerated as an "organization" on July 04, 2007.

Where is the provider located?

The provider is located at 12 EVERETT ST EAST ORANGE, NJ 07017 and the phone number is (973) 678-3030.

What is the provider's specialty?

Private Vehicle with taxonomy code 347C00000X.