Provider Demographics
NPI:1285363283
Name:PUIT, ELIANA (NP)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:PUIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELIANA
Other - Middle Name:
Other - Last Name:VALLEJOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2500 ENGLISH CREEK AVE BLDG 1200
Mailing Address - Street 2:SECOND FL
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5549
Mailing Address - Country:US
Mailing Address - Phone:609-833-9833
Mailing Address - Fax:
Practice Address - Street 1:2500 ENGLISH CREEK AVE BLDG 1200
Practice Address - Street 2:SECOND FL
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5549
Practice Address - Country:US
Practice Address - Phone:609-833-9833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01317800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner