Provider Demographics
NPI:1306830278
Name:EUSTACE, DEBRA M (RNFA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:M
Last Name:EUSTACE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SIDNEY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3510
Mailing Address - Country:US
Mailing Address - Phone:908-735-8463
Mailing Address - Fax:908-713-9691
Practice Address - Street 1:240 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-565-5410
Practice Address - Fax:732-937-9311
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07860900163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant