Provider Demographics
NPI:1063076685
Name:EAGLE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:EAGLE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-262-4936
Mailing Address - Street 1:18 FERRY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1436
Mailing Address - Country:US
Mailing Address - Phone:973-589-3566
Mailing Address - Fax:973-589-1707
Practice Address - Street 1:18 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1436
Practice Address - Country:US
Practice Address - Phone:732-255-2252
Practice Address - Fax:848-444-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty