| Doctor Name: | ELEANOR D MIKRUT |
| NPI Number: | 1649378811 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CAPN |
| License Number: | 26NN07572600 |
| Business Practice Address: | 154 Tamarack Cir Skillman, NJ - 085582021 |
| Business Phone Number: | 6099245250 |
| Business Fax Number: | 6099248113 |
| Mailing Address: | 13 Berwick St, RARITAN |
| State: | NJ |
| Postal Code: | 088691607 |
| Phone Number: | 9085261650 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 01/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 26NN07572600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |