Provider Demographics
NPI:1114699063
Name:SANIC, ELIANA DE LOS ANGELES
Entity Type:Individual
Prefix:
First Name:ELIANA
Middle Name:DE LOS ANGELES
Last Name:SANIC
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 1:415 DEKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-2707
Mailing Address - Country:US
Mailing Address - Phone:609-964-8070
Mailing Address - Fax:
Practice Address - Street 1:415 DEKLYN AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-2707
Practice Address - Country:US
Practice Address - Phone:609-964-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula