Individual
MRS. LOURAINE EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
769 NORTHFIELD AVE, SUITE 140, WEST ORANGE, NJ 07052-1198
(973) 731-6565
(973) 731-9855
Mailing address
769 NORTHFIELD AVE, SUITE 140, WEST ORANGE, NJ 07052-1198
(973) 731-6565
(973) 731-9855
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0584681
CIGNA
NJ
01
—
2234854
UNITED HEALTHCARE
NJ
01
—
2959549
AETNA
NJ
01
—
P2951858
OXFORD
NJ
Enumeration date
10/17/2007
Last updated
10/17/2007
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