Provider Demographics
NPI:1003564733
Name:EUGENE, PATRICIA DESROCHES (FNLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DESROCHES
Last Name:EUGENE
Suffix:
Gender:F
Credentials:FNLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 NORTHFIELD AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3091
Mailing Address - Country:US
Mailing Address - Phone:201-762-5090
Mailing Address - Fax:551-210-1912
Practice Address - Street 1:419 NORTHFIELD AVE STE 1
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3091
Practice Address - Country:US
Practice Address - Phone:201-762-5090
Practice Address - Fax:551-210-1912
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education