Provider Demographics
NPI:1932307790
Name:ELIACIN, PATRICIA (DNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:ELIACIN
Suffix:
Gender:F
Credentials:DNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PENN PLZ E
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2258
Mailing Address - Country:US
Mailing Address - Phone:973-963-4402
Mailing Address - Fax:
Practice Address - Street 1:3 PENN PLZ E
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2258
Practice Address - Country:US
Practice Address - Phone:973-466-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304014363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health