Doctor Name: | EILEEN REID |
NPI Number: | 1144681370 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | F339965-1 |
Business Practice Address: | 60 Hernan Ave Locust Valley, NY - 11560 |
Business Phone Number: | 5163613217 |
Business Fax Number: | |
Mailing Address: | 101 Saint Andrews Lane, GLEN COVE |
State: | NY |
Postal Code: | 11542 |
Phone Number: | 5166747380 |
Fax Number: | 5166747374 |
NPI Enumeration Date: | 03/16/2016 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F339965-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |