Provider Demographics
NPI:1972756088
Name:ESTONACTOC, BARBARA VALERA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:VALERA
Last Name:ESTONACTOC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:VALERA
Other - Last Name:ESTONACTOC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:90 CROSBY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4215
Mailing Address - Country:US
Mailing Address - Phone:732-572-8909
Mailing Address - Fax:
Practice Address - Street 1:90 CROSBY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4215
Practice Address - Country:US
Practice Address - Phone:732-572-8909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11403500163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical