Healthcare Provider Details

I. General information

NPI: 1821466483
Provider Name (Legal Business Name): EILEEN AROCHO, RDN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SUMMIT AVE
HACKENSACK NJ
07601-1311
US

IV. Provider business mailing address

46 RUTGERS LN
PARSIPPANY NJ
07054-4215
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-5892
  • Fax:
Mailing address:
  • Phone: 845-505-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number86008379
License Number StateNJ

VIII. Authorized Official

Name: EILEEN BAKER
Title or Position: OWNER
Credential: RDN
Phone: 845-505-5507