Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tristate Domestic, LLC

Organization Home Health Agency · NPI 1164620803

Tristate Domestic, LLC is a Home Health Agency in East Orange, New Jersey. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12 Everett St
East Orange, NJ 07017-1740
Phone: (973) 678-3030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Private Vehicle (primary) Taxonomy 347C00000X
Home Health Agency Taxonomy 251E00000X
Non-emergency Medical Transport (VAN) Taxonomy 343900000X

Record details

NPI number1164620803
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dominick Iacoviello — President · (973) 678-3030
NPI enumeratedJuly 4, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address12 Everett St, East Orange, NJ 07017-1740

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