Provider Demographics
NPI:1306594809
Name:VALENCIA, ELOISE JOELYN (APN)
Entity type:Individual
Prefix:
First Name:ELOISE
Middle Name:JOELYN
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ATNO AVE
Mailing Address - Street 2:
Mailing Address - City:HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07843-1342
Mailing Address - Country:US
Mailing Address - Phone:973-489-8632
Mailing Address - Fax:
Practice Address - Street 1:105 RAIDER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1528
Practice Address - Country:US
Practice Address - Phone:908-281-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01281200207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease